Moving Targets: Fighting the Evolution of Resistance in Infections, Pests, and Cancer

Do you think the oncologists at a cutting-edge research hospital ever sit down with local farmers? Do you think the pharmaceutical researchers developing the next generation of anti-HIV drugs spend any time with the plant scientists working on the next generation of Roundup Ready soybeans?

If your answer to both questions is no, you would be mostly right. Even though all of these people are dealing with exactly the same evolutionary phenomena, they do not recognize themselves as a single scientific community and rarely get a chance to learn from each other. What they all have in common is that they are trying to eliminate an unwanted living entity – a cancer cell, a weed, a virus, an insect pest – but the treatments they develop eventually lose effectiveness because the target evolves resistance.

The emergence of resistance is a phenomenon with ancient evolutionary roots, although the human role in triggering resistance was little appreciated before the advent of widespread antibiotic and pesticide use in the 1950s. In Silent Spring, the prescient Rachel Carson wrote in 1962 that “by their very nature chemical controls are self-defeating, for they have been devised and applied without taking into account the complex biological systems against which they have been blindly hurled.” Sadly, in the fifty years which have elapsed since Silent Spring was published, biologists, doctors, and farmers continue to be plagued with resistance evolution by the species they seek to control. This phenomenon is witnessed in medicine in the emergence of antibiotic resistance and when tumors become intractable to standard anti-cancer medications, in agriculture when insecticides and herbicides lose effectiveness, and in public health when disease-carrying insects develop resistance to control strategies.

Despite the ubiquity of the resistance phenomenon, the communities of scientists that study resistance in different contexts rarely have the opportunity to share lessons learned, or to consider the possibility that common evolutionary or mechanistic principles may be at work across their different biological systems. The American Academy of Microbiology convened a diverse group of experts to explore the intriguing concept that the evolution of resistance can, and should, be one of the primary criteria in drug design and treatment implementation. The scientists discussed the shared biological principles influencing the evolution of resistance across diverse biological systems and explored whether understanding and incorporating consideration of those mechanisms could lead to a generation of therapies more effective for individual patients, farmers, and public health organizations. The results of their fascinating discussion are reported in “Moving targets: Fighting resistance in infections, pests, and cancer.”