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. 2021 May 31;9(5):e002032. doi: 10.1136/jitc-2020-002032

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.

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A tipping point in the tumor-immune interaction determines a patient’s outcome. (A) A gradual increase in tumor growth reveals a tipping point, where long-term survival (immune control; inset 1) abruptly changes to short-term survival (immune evasion; inset 2). (B) A similar analysis reveals a tipping point along the immune axis, again differentiating short-term survival (immune evasion; inset 1) from long-term control (immune control; inset 2). (C) The tipping point is present across the entire range of parameters examined. Cure and progressive disease are the dominant states, whereas subclinical tumor control only occurs within a limited parameter range (inset). Simulation parameters are shown in online supplemental table 2. OS, overall survival.