查看“适应性治疗”的源代码

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            <strong>[[适应性治疗]] (Adaptive Therapy)</strong> 是一种基于 <strong>[[进化博弈论]] (Evolutionary Game Theory)</strong> 的癌症管理模式。其核心观点认为，癌症并非静态的肿块，而是由 <strong>[[敏感克隆]]</strong> 和 <strong>[[耐药克隆]]</strong> 组成的动态生态系统。传统治疗由于采用“最大耐受剂量 (MTD)”，往往杀死了所有竞争对手（敏感克隆），反而为耐药克隆提供了爆发式增长的“生态真空”。适应性治疗通过动态调整剂量，利用敏感细胞的生长优势来竞争性抑制耐药细胞，从而实现肿瘤负荷的长期稳定。
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            <div style="font-size: 1.25em; font-weight: bold; letter-spacing: 1.2px;">适应性治疗</div>
            <div style="font-size: 0.7em; opacity: 0.85; margin-top: 4px; white-space: nowrap;">Adaptive Therapy · 核心档案</div>
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                <div style="font-size: 0.8em; color: #64748b; margin-top: 10px; font-weight: 600;">核心任务：维持克隆平衡</div>
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                    <td colspan="2" style="padding: 6px; border-bottom: 1px solid #e2e8f0;">治疗逻辑对比</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc; border-bottom: 1px solid #f1f5f9;">给药目标</th>
                    <td style="padding: 6px 10px; border-bottom: 1px solid #f1f5f9;">维持稳态 vs 彻底清除</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc; border-bottom: 1px solid #f1f5f9;">剂量逻辑</th>
                    <td style="padding: 6px 10px; border-bottom: 1px solid #f1f5f9;">动态调整 vs 最大耐受剂量 (MTD)</td>
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                    <td colspan="2" style="padding: 6px; border-bottom: 1px solid #e2e8f0;">关键生物学机制</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc; border-bottom: 1px solid #f1f5f9;">进化代价</th>
                    <td style="padding: 6px 10px; border-bottom: 1px solid #f1f5f9;">[[适应度代价 (Fitness Cost)]]</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc; border-bottom: 1px solid #f1f5f9;">竞争形式</th>
                    <td style="padding: 6px 10px; border-bottom: 1px solid #f1f5f9;">资源竞争、空间竞争</td>
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                    <td colspan="2" style="padding: 6px; border-bottom: 1px solid #e2e8f0;">实施与监测</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc; border-bottom: 1px solid #f1f5f9;">检测手段</th>
                    <td style="padding: 6px 10px; border-bottom: 1px solid #f1f5f9;">[[液体活检]] (ctDNA)、影像学</td>
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                    <th style="text-align: left; padding: 6px 10px; background-color: #f8fafc;">预测工具</th>
                    <td style="padding: 6px 10px;">[[AI 耐药轨迹预测]]、数学建模</td>
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        适应性治疗之所以有效，源于进化生物学中的一个核心定律：<strong>耐药是有代价的</strong>。
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        <li style="margin-bottom: 12px;"><strong>能量分配冲突：</strong> 耐药细胞需要将大量能量用于运行 <strong>[[外排泵 (Efflux Pumps)]]</strong> 或修复 DNA 损伤。在无药环境下，其生长速度远低于资源全速用于分裂的敏感细胞。</li>
        <li style="margin-bottom: 12px;"><strong>竞争性抑制：</strong> 通过间歇性给药，人为保留一部分 <strong>[[敏感克隆]]</strong>。在停药期，敏感细胞会迅速占据空间和营养资源，使耐药细胞处于“被压制”状态，防止其演化为主要克隆。</li>
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            [1] <strong>Zhang, J., et al. (2017).</strong> <em>Integrating evolutionary dynamics into treatment of metastatic castrate-resistant prostate cancer.</em> <strong>Nature Communications</strong>, 8(1), 1816.<br>
            <span style="color: #475569;">[核心价值]：该研究通过 <strong>[[阿比特龙]]</strong> 的适应性给药试验，证明其可将 <strong>[[前列腺癌]]</strong> 的中位进展时间延长 20 个月以上。</span>
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            [2] <strong>Gatenby, R. A., et al. (2009).</strong> <em>Adaptive Therapy.</em> <strong>Cancer Research</strong>, 69(11), 4894-4903.<br>
            <span style="color: #475569;">[理论基石]：正式提出了利用生态学原理（Eco-Evo）通过维持克隆竞争来管理癌症的理论框架。</span>
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            [3] <strong>Enriquez-Navas, P. M., et al. (2016).</strong> <em>Relation between tumor growth and toxicity in cytotoxic chemotherapy.</em> <strong>Science Translational Medicine</strong>, 8(327).<br>
            <span style="color: #475569;">[机制证明]：在乳腺癌小鼠模型中证明，低剂量适应性化疗比高剂量持续化疗能更有效地控制肿瘤体积。</span>
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            [4] <strong>West, J. B., et al. (2023).</strong> <em>Evolution-based oncology: the clinical translation of adaptive therapy.</em> <strong>Nature Reviews Clinical Oncology</strong>, 20(8).<br>
            <span style="color: #475569;">[前沿进展]：综述了 <strong>[[AI]]</strong> 与 <strong>[[数学建模]]</strong> 如何辅助精准确定停药与复药的阈值。</span>
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            <li style="margin-bottom: 8px;"><strong>[[肿瘤异质性]]：</strong> 适应性治疗实施的前提，即肿瘤内存在不同的细胞克隆。</li>
            <li style="margin-bottom: 8px;"><strong>[[液体活检]]：</strong> 利用 <strong>[[ctDNA]]</strong> 动态追踪肿瘤演化的窗口。</li>
            <li style="margin-bottom: 8px;"><strong>[[耐药谱图分析]]：</strong> 确定敏感细胞与耐药细胞比例的基础。</li>
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            适应性治疗 · 知识图谱
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                <td style="width: 110px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">进化逻辑</td>
                <td style="padding: 10px 15px; color: #334155;">[[博弈论模型]]•[[负频率依赖选择]]•[[生态龛位竞争]]</td>
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                <td style="width: 110px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">实施工具</td>
                <td style="padding: 10px 15px; color: #334155;">[[PSA 监测]]•[[单细胞测序监测]]•[[AI 剂量计算]]</td>
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                <td style="width: 110px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">临床挑战</td>
                <td style="padding: 10px 15px; color: #334155;">[[生物标志物滞后性]]•[[患者停药焦虑]]•[[克隆漂移预测]]</td>
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