Most cancer treatments are based on using the maximum tolerated dose of a drug to kill as many cancer cells as possible. While this approach has led to patients achieving good responses to therapy, most patients develop drug resistance and disease recurrence. Researchers in the Center of Excellence for Evolutionary Therapy at Moffitt Cancer Center have been investigating an alternative treatment approach called adaptive therapy that focuses on maintaining disease control instead of complete tumor cell elimination. In a new study published in Communications Medicine, the researchers used mathematical modeling to reveal that the spatial organization of a tumor is an important factor that governs how cells compete with one another and the effectiveness of adaptive therapy.