The ATR (ataxia telangiectasia mutated and rad3-related kinase) inhibitor AZD6738 is an anti-cancer drug that potentially hinders tumour proliferation by targeting cellular DNA damage responses. In this study, we combine a systems pharmacology approach with an agent-based modelling approach to simulate AZD6738 treatment responses in silico. The mathematical model is governed by a set of empirically observable rules. By adjusting only the rules, whilst keeping the fundamental mathematical framework and model parameters intact, the mathematical model can first be calibrated by in vitro data and thereafter be used to successfully predict treatment responses in human tumour xenografts in vivo qualitatively, and quantitatively up to approximately 10 days post tumour injection.The deoxyribonucleic acid (DNA) in human cells is perpetually exposed to influences that are potentially harmful. These influences can be derived from both exogenous and endogenous sources and events [1, 2]. Exogenous sources include ultraviolet radiation, ionising radiation (IR) and chemotherapeutic drugs [1], whilst erroneous DNA replication is an example an endogenous event yielding DNA damage [1]. Regardless of the source, a multitude of intracellular events are triggered when the DNA in a cell is damaged. For example, cells may respond to DNA damage by activating DNA repair mechanisms, cell cycle arrest or, in cases of severe DNA damage, apoptosis [3]. Cellular responses to DNA damage are mainly governed by the DNA damage response (DDR) pathway, which comprises a complex network of signaling pathways [3]. The DDR pathway has many functionalities. Amongst other things, the DDR pathway monitors DNA integrity and repairs DNA damage in order to maintain genomic stability in cells. The DDR pathway also governs DNA replication and cell cycle progression, and it controls apoptosis [1,4]. From this, it is clear that the DDR pathway is crucial for maintaining cell viability. When DNA repair is needed, the DDR activates effector proteins [1]. Included in the group of effector proteins are approximately 450 proteins associated with the DDR [4], out of which the two main regulators for cell cycle checkpoints are ataxia telangiectasia mutated kinase (ATM) and ataxia telangiectasia mutated and rad3-related kinase (ATR) [2]. ATM and ATR are two proteins belonging to the enzyme family phosphatidyilinositol-3-OH-kinases (PI3K), and they both play central roles when cells respond to DNA damage [3].The two principle types of DNA lesions are double-strand DNA breaks and single-strand DNA breaks [1]. Double-strand breaks are typically induced by IR [2], and ATM is the central protein involved in repairing double-strand breaks [1]. Single-strand breaks are a common result of replication stress [5] and the repair of single-strand DNA breaks is mainly attributed to ATR activity. ATR is active in the checkpoint in the intra-S phase of the cell cycle, both under undamaged circumstances and in response to DNA damage [3]. Although cross-talk between ATM and ATR regulat...