Fig. 2.

Simulation results. Computer simulations of mCRPC growth during conventional maximum tolerated dose, metronomic, and adaptive application of abiraterone where the gray background indicates administration of abiraterone in Patient #1. a shows underlying population dynamics of a tumor if left untreated. b shows continuous application of abiraterone resulting in competitive release of T− cells and tumor progression. c panel shows a metronomic therapy similar to ADT intermittent therapy study where the lengthy induction period and further abiraterone is given at predetermined intervals. This shows that the benefit gained from adaptive therapies is not just the decrease in drug dosage but is indeed the evolutionary guided timing of the cycles. d shows a short administration of abiraterone decreasing the TP and T+ cells. However, abiraterone is discontinued when the PSA falls below 50% of the pretreatment value (Fig. 3). This permits recovery of TP and T+ cells, reverses the increase in T− cells, and prevents competitive release. After each treatment cycle, the tumor subpopulations remain nearly identical in size and composition