Gompertzian Model of Tumor Growth

With further studies, it became clear that Skipper's model was oversimplified and applied only to the proliferating segment within the tumor. Some early-stage malignancies, such as testicular germ cell tumor, may behave in such a way when they are composed of proliferating cells highly responsive to chemotherapeutic agents. However, most human solid tumors do not respond to chemotherapy, contrary to what would have been expected if tumor growth was exponential. Rather, the experimental data in human solid tumors support the Gompertzian kinetics of tumor growth, akin to the sigmoid curve seen in microbial kinetics under a controlled environment, where the initial growth phase is steep at smaller volumes, eventually plateauing and decreasing with time once a critical mass is reached4 (Figure 2.2). As many anticancer agents are cell cycle specific and are usually most active against cells that are proliferating, a critical factor in drug responsiveness of tumors to cell-cycle-specific drugs depends on the particular phase the tumor is in its growth curve. This model also helps explain why, unless cure was effected, varying degrees of residual tumor volume result in similar relapse-free survival over time.

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