Antifragile therapy

Antifragility is a recently coined word used to describe the opposite of fragility. Systems or organisms can be described as antifragile if they derive a benefit from systemic variability, volatility, randomness, or disorder. Herein, we introduce a mathematical framework to quantify the fragility or antifragility of cancer cell lines in response to treatment variability. This framework enables straightforward prediction of the optimal dose treatment schedule for a range of treatment schedules with identical cumulative dose. We apply this framework to non-small-cell lung cancer cell lines with evolved resistance to ten anti-cancer drugs. We show the utility of this antifragile framework when applied to 1) treatment resistance, and 2) collateral sensitivity of sequential monotherapies.