  One of the main reasons we have not been able to cure cancers is that drugs
select for drug-resistant cancer cells. Pest managers face similar challenges
with pesticides selecting for pesticide-resistant organisms. Lessons in pest
management have led to four heuristics that can be translated to controlling
cancers 1. limit use (of chemical controls or modes of action to the lowest
practical levels) 2. diversify use (of modes of action largely through
rotations of chemical controls) 3. partition chemistry (modes of action through
space and time, which in effect is a refuge management strategy) and 4. include
non-chemical methods. These principles are general to all cancers and cancer
drugs, and thus should be employed to improve oncology. We review the parallel
difficulties in controlling the evolution of drug resistance in pests and
cancer cells, and describe the results of single- and multi-drug strategies in
agriculture and oncology. We dissect the methods that pest managers use to
prevent the evolution of pesticide resistance, showing how integrated pest
management inspired the development of adaptive therapy in oncology to
stabilize tumor size, and increase progression-free survival and quality of
life of patients. Finally, we demonstrate these principles in a proposal for
clinical trials in colorectal cancer.
