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Sánchez JF, Ramtani S, Boucetta A, Velasco MA, Vaca-González JJ, Duque-Daza CA, Garzón-Alvarado DA. Tumor growth for remodeling process: A 2D approach. J Theor Biol 2024; 585:111781. [PMID: 38432504 DOI: 10.1016/j.jtbi.2024.111781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
This paper aims to present a comprehensive framework for coupling tumor-bone remodeling processes in a 2-dimensional geometry. This is achieved by introducing a bio-inspired damage that represents the growing tumor, which subsequently affects the main populations involved in the remodeling process, namely, osteoclasts, osteoblasts, and bone tissue. The model is constructed using a set of differential equations based on the Komarova's and Ayati's models, modified to incorporate the bio-inspired damage that may result in tumor mass formation. Three distinct models were developed. The first two models are based on the Komarova's governing equations, with one demonstrating an osteolytic behavior and the second one an osteoblastic model. The third model is a variation of Ayati's model, where the bio-inspired damage is induced through the paracrine and autocrine parameters, exhibiting an osteolytic behavior. The obtained results are consistent with existing literature, leading us to believe that our in-silico experiments will serve as a cornerstone for paving the way towards targeted interventions and personalized treatment strategies, ultimately improving the quality of life for those affected by these conditions.
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Affiliation(s)
| | - Salah Ramtani
- Laboratoire CSPBAT, equipe LBPS, CNRS (UMR 7244), Universit e Sorbonne Paris Nord, France.
| | - Abdelkader Boucetta
- Laboratoire CSPBAT, equipe LBPS, CNRS (UMR 7244), Universit e Sorbonne Paris Nord, France
| | | | - Juan Jairo Vaca-González
- Escuela de Pregrado - Direccion Académica, Universidad Nacional de Colombia, Sede de La Paz, Colombia.
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2
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Browning AP, Lewin TD, Baker RE, Maini PK, Moros EG, Caudell J, Byrne HM, Enderling H. Predicting Radiotherapy Patient Outcomes with Real-Time Clinical Data Using Mathematical Modelling. Bull Math Biol 2024; 86:19. [PMID: 38238433 PMCID: PMC10796515 DOI: 10.1007/s11538-023-01246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/14/2023] [Indexed: 01/22/2024]
Abstract
Longitudinal tumour volume data from head-and-neck cancer patients show that tumours of comparable pre-treatment size and stage may respond very differently to the same radiotherapy fractionation protocol. Mathematical models are often proposed to predict treatment outcome in this context, and have the potential to guide clinical decision-making and inform personalised fractionation protocols. Hindering effective use of models in this context is the sparsity of clinical measurements juxtaposed with the model complexity required to produce the full range of possible patient responses. In this work, we present a compartment model of tumour volume and tumour composition, which, despite relative simplicity, is capable of producing a wide range of patient responses. We then develop novel statistical methodology and leverage a cohort of existing clinical data to produce a predictive model of both tumour volume progression and the associated level of uncertainty that evolves throughout a patient's course of treatment. To capture inter-patient variability, all model parameters are patient specific, with a bootstrap particle filter-like Bayesian approach developed to model a set of training data as prior knowledge. We validate our approach against a subset of unseen data, and demonstrate both the predictive ability of our trained model and its limitations.
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Affiliation(s)
| | - Thomas D Lewin
- Mathematical Institute, University of Oxford, Oxford, UK
- Roche Pharma Research and Early Development, Roche Innovation Center, Basel, Switzerland
| | - Ruth E Baker
- Mathematical Institute, University of Oxford, Oxford, UK
| | - Philip K Maini
- Mathematical Institute, University of Oxford, Oxford, UK
| | - Eduardo G Moros
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Jimmy Caudell
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - Helen M Byrne
- Mathematical Institute, University of Oxford, Oxford, UK
| | - Heiko Enderling
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA.
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA.
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA.
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3
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Mohsin N, Enderling H, Brady-Nicholls R, Zahid MU. Simulating tumor volume dynamics in response to radiotherapy: Implications of model selection. J Theor Biol 2024; 576:111656. [PMID: 37952611 DOI: 10.1016/j.jtbi.2023.111656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/27/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
From the beginning of the usage of radiotherapy (RT) for cancer treatment, mathematical modeling has been integral to understanding radiobiology and for designing treatment approaches and schedules. There has been extensive modeling of response to RT with the inclusion of various degrees of biological complexity. In this study, we compare three models of tumor volume dynamics: (1) exponential growth with RT directly reducing tumor volume, (2) logistic growth with direct tumor volume reduction, and (3) logistic growth with RT reducing the tumor carrying capacity with the objective of understanding the implications of model selection and informing the process of model calibration and parameterization. For all three models, we: examined the rates of change in tumor volume during and RT treatment course; performed parameter sensitivity and identifiability analyses; and investigated the impact of the parameter sensitivity on the tumor volume trajectories. In examining the tumor volume dynamics trends, we coined a new metric - the point of maximum reduction of tumor volume (MRV) - to quantify the magnitude and timing of the expected largest impact of RT during a treatment course. We found distinct timing differences in MRV, dependent on model selection. The parameter identifiability and sensitivity analyses revealed the interdependence of the different model parameters and that it is only possible to independently identify tumor growth and radiation response parameters if the underlying tumor growth rate is sufficiently large. Ultimately, the results of these analyses help us to better understand the implications of model selection while simultaneously generating falsifiable hypotheses about MRV timing that can be tested on longitudinal measurements of tumor volume from pre-clinical or clinical data with high acquisition frequency. Although, our study only compares three particular models, the results demonstrate that caution is necessary in selecting models of response to RT, given the artifacts imposed by each model.
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Affiliation(s)
- Nuverah Mohsin
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Heiko Enderling
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Institute for Data Science in Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Renee Brady-Nicholls
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
| | - Mohammad U Zahid
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
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4
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Christenson C, Wu C, Hormuth DA, Huang S, Bao A, Brenner A, Yankeelov TE. Predicting the spatio-temporal response of recurrent glioblastoma treated with rhenium-186 labelled nanoliposomes. BRAIN MULTIPHYSICS 2023; 5:100084. [PMID: 38187909 PMCID: PMC10768931 DOI: 10.1016/j.brain.2023.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Rhenium-186 (186Re) labeled nanoliposome (RNL) therapy for recurrent glioblastoma patients has shown promise to improve outcomes by locally delivering radiation to affected areas. To optimize the delivery of RNL, we have developed a framework to predict patient-specific response to RNL using image-guided mathematical models. Methods We calibrated a family of reaction-diffusion type models with multi-modality imaging data from ten patients (NCR01906385) to predict the spatio-temporal dynamics of each patient's tumor. The data consisted of longitudinal magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) to estimate tumor burden and local RNL activity, respectively. The optimal model from the family was selected and used to predict future growth. A simplified version of the model was used in a leave-one-out analysis to predict the development of an individual patient's tumor, based on cohort parameters. Results Across the cohort, predictions using patient-specific parameters with the selected model were able to achieve Spearman correlation coefficients (SCC) of 0.98 and 0.93 for tumor volume and total cell number, respectively, when compared to the measured data. Predictions utilizing the leave-one-out method achieved SCCs of 0.89 and 0.88 for volume and total cell number across the population, respectively. Conclusion We have shown that patient-specific calibrations of a biology-based mathematical model can be used to make early predictions of response to RNL therapy. Furthermore, the leave-one-out framework indicates that radiation doses determined by SPECT can be used to assign model parameters to make predictions directly following the conclusion of RNL treatment. Statement of Significance This manuscript explores the application of computational models to predict response to radionuclide therapy in glioblastoma. There are few, to our knowledge, examples of mathematical models used in clinical radionuclide therapy. We have tested a family of models to determine the applicability of different radiation coupling terms for response to the localized radiation delivery. We show that with patient-specific parameter estimation, we can make accurate predictions of future glioblastoma response to the treatment. As a comparison, we have shown that population trends in response can be used to forecast growth from the moment the treatment has been delivered.In addition to the high simulation and prediction accuracy our modeling methods have achieved, the evaluation of a family of models has given insight into the response dynamics of radionuclide therapy. These dynamics, while different than we had initially hypothesized, should encourage future imaging studies involving high dosage radiation treatments, with specific emphasis on the local immune and vascular response.
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Affiliation(s)
| | - Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - David A. Hormuth
- Livestrong Cancer Institutes, USA
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Shiliang Huang
- Department of Oncology, The University of Texas Health Sciences Center at San Antonio, San Antonio, TX 78229, USA
| | - Ande Bao
- Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Andrew Brenner
- Department of Oncology, The University of Texas Health Sciences Center at San Antonio, San Antonio, TX 78229, USA
| | - Thomas E. Yankeelov
- Departments of Biomedical Engineering, USA
- Departments of Diagnostic Medicine, USA
- Departments of Oncology, USA
- Livestrong Cancer Institutes, USA
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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Hillen T, Loy N, Painter KJ, Thiessen R. Modelling microtube driven invasion of glioma. J Math Biol 2023; 88:4. [PMID: 38015257 PMCID: PMC10684558 DOI: 10.1007/s00285-023-02025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023]
Abstract
Malignant gliomas are notoriously invasive, a major impediment against their successful treatment. This invasive growth has motivated the use of predictive partial differential equation models, formulated at varying levels of detail, and including (i) "proliferation-infiltration" models, (ii) "go-or-grow" models, and (iii) anisotropic diffusion models. Often, these models use macroscopic observations of a diffuse tumour interface to motivate a phenomenological description of invasion, rather than performing a detailed and mechanistic modelling of glioma cell invasion processes. Here we close this gap. Based on experiments that support an important role played by long cellular protrusions, termed tumour microtubes, we formulate a new model for microtube-driven glioma invasion. In particular, we model a population of tumour cells that extend tissue-infiltrating microtubes. Mitosis leads to new nuclei that migrate along the microtubes and settle elsewhere. A combination of steady state analysis and numerical simulation is employed to show that the model can predict an expanding tumour, with travelling wave solutions led by microtube dynamics. A sequence of scaling arguments allows us reduce the detailed model into simpler formulations, including models falling into each of the general classes (i), (ii), and (iii) above. This analysis allows us to clearly identify the assumptions under which these various models can be a posteriori justified in the context of microtube-driven glioma invasion. Numerical simulations are used to compare the various model classes and we discuss their advantages and disadvantages.
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Affiliation(s)
- Thomas Hillen
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Canada.
| | - Nadia Loy
- Department of Mathematical Sciences (DISMA), Politecnico di Torino, Turin, Italy
| | - Kevin J Painter
- Interuniversity Department of Regional and Urban Studies and Planning (DIST), Politecnico di Torino, Turin, Italy
| | - Ryan Thiessen
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Canada
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6
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Shah F, Hamilton LOW, Yiannakis CP, Slim MAM, Kontorinis G. A systematic review and meta-analysis of stereotactic radiosurgery as a primary treatment in fast-growing vestibular schwannomas. J Laryngol Otol 2023; 137:1193-1199. [PMID: 37194631 DOI: 10.1017/s0022215123000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Stereotactic radiosurgery has been shown to be an effective method of managing vestibular schwannomas. The primary aim here is to establish the impact of pre-treatment fast-growing vestibular schwannomas on the efficacy of stereotactic radiosurgery. METHODS PubMed, Medline and Embase databases were used. The ROBINS-I ('Risk Of Bias In Non-randomised Studies - of Interventions') tool was utilised to assess for risk of bias. Proportionate meta-analysis and sub-analysis for fast-growing tumours were performed to explore the success rate of stereotactic radiosurgery in stabilising or decreasing the tumour burden in vestibular schwannomas. RESULTS Four moderate risk studies were included in the analysis. Overall, 91 per cent (95 per cent confidence interval = 0.83-0.97, p < 0.01, I2 = 80 per cent) of the tumours demonstrated successful size reduction or stabilisation following stereotactic radiosurgery. Nevertheless, the efficacy of stereotactic radiosurgery in reducing or stabilising fast-growing vestibular schwannomas decreased by 79 per cent (95 per cent confidence interval = 0.64-0.91, p = 0.11, I2 = 62 per cent). CONCLUSION Stereotactic radiosurgery has a statistically significant success rate in stabilising or decreasing the vestibular schwannoma size. This success rate is diminished in fast-growing vestibular schwannomas.
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Affiliation(s)
- Faizan Shah
- ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
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7
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Das A, Ding S, Liu R, Huang C. Quantifying the Growth of Glioblastoma Tumors Using Multimodal MRI Brain Images. Cancers (Basel) 2023; 15:3614. [PMID: 37509277 PMCID: PMC10377296 DOI: 10.3390/cancers15143614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Predicting the eventual volume of tumor cells, that might proliferate from a given tumor, can help in cancer early detection and medical procedure planning to prevent their migration to other organs. In this work, a new statistical framework is proposed using Bayesian techniques for detecting the eventual volume of cells expected to proliferate from a glioblastoma (GBM) tumor. Specifically, the tumor region was first extracted using a parallel image segmentation algorithm. Once the tumor region was determined, we were interested in the number of cells that could proliferate from this tumor until its survival time. For this, we constructed the posterior distribution of the tumor cell numbers based on the proposed likelihood function and a certain prior volume. Furthermore, we extended the detection model and conducted a Bayesian regression analysis by incorporating radiomic features to discover those non-tumor cells that remained undetected. The main focus of the study was to develop a time-independent prediction model that could reliably predict the ultimate volume a malignant tumor of the fourth-grade severity could attain and which could also determine if the incorporation of the radiomic properties of the tumor enhanced the chances of no malignant cells remaining undetected.
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Affiliation(s)
- Anisha Das
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
| | - Shengxian Ding
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
| | - Rongjie Liu
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
| | - Chao Huang
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA
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8
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Wilson N, Drapaca CS, Enderling H, Caudell JJ, Wilkie KP. Modelling Radiation Cancer Treatment with a Death-Rate Term in Ordinary and Fractional Differential Equations. Bull Math Biol 2023; 85:47. [PMID: 37186175 PMCID: PMC10127975 DOI: 10.1007/s11538-023-01139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/28/2023] [Indexed: 05/17/2023]
Abstract
Fractional calculus has recently been applied to the mathematical modelling of tumour growth, but its use introduces complexities that may not be warranted. Mathematical modelling with differential equations is a standard approach to study and predict treatment outcomes for population-level and patient-specific responses. Here, we use patient data of radiation-treated tumours to discuss the benefits and limitations of introducing fractional derivatives into three standard models of tumour growth. The fractional derivative introduces a history-dependence into the growth function, which requires a continuous death-rate term for radiation treatment. This newly proposed radiation-induced death-rate term improves computational efficiency in both ordinary and fractional derivative models. This computational speed-up will benefit common simulation tasks such as model parameterization and the construction and running of virtual clinical trials.
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Affiliation(s)
- Nicole Wilson
- Department of Mathematics, Toronto Metropolitan University, Toronto, Canada
| | - Corina S Drapaca
- Engineering Science and Mechanics, Pennsylvania State University, University Park, USA
| | - Heiko Enderling
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Jimmy J Caudell
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Kathleen P Wilkie
- Department of Mathematics, Toronto Metropolitan University, Toronto, Canada.
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9
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Plaszczynski S, Grammaticos B, Pallud J, Campagne JE, Badoual M. Predicting regrowth of low-grade gliomas after radiotherapy. PLoS Comput Biol 2023; 19:e1011002. [PMID: 37000852 PMCID: PMC10128962 DOI: 10.1371/journal.pcbi.1011002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 04/25/2023] [Accepted: 03/04/2023] [Indexed: 04/03/2023] Open
Abstract
Diffuse low grade gliomas are invasive and incurable brain tumors that inevitably transform into higher grade ones. A classical treatment to delay this transition is radiotherapy (RT). Following RT, the tumor gradually shrinks during a period of typically 6 months to 4 years before regrowing. To improve the patient’s health-related quality of life and help clinicians build personalized follow-ups, one would benefit from predictions of the time during which the tumor is expected to decrease. The challenge is to provide a reliable estimate of this regrowth time shortly after RT (i.e. with few data), although patients react differently to the treatment. To this end, we analyze the tumor size dynamics from a batch of 20 high-quality longitudinal data, and propose a simple and robust analytical model, with just 4 parameters. From the study of their correlations, we build a statistical constraint that helps determine the regrowth time even for patients for which we have only a few measurements of the tumor size. We validate the procedure on the data and predict the regrowth time at the moment of the first MRI after RT, with precision of, typically, 6 months. Using virtual patients, we study whether some forecast is still possible just three months after RT. We obtain some reliable estimates of the regrowth time in 75% of the cases, in particular for all “fast-responders”. The remaining 25% represent cases where the actual regrowth time is large and can be safely estimated with another measurement a year later. These results show the feasibility of making personalized predictions of the tumor regrowth time shortly after RT.
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Affiliation(s)
- Stéphane Plaszczynski
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Université Paris-Cité, IJCLab, Orsay, France
- * E-mail:
| | - Basile Grammaticos
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Université Paris-Cité, IJCLab, Orsay, France
| | - Johan Pallud
- Department of Neurosurgery, GHU Paris Sainte-Anne Hospital, Paris, France
- Université de Paris, Sorbonne Paris Cité, Paris, France
- Inserm, U1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Jean-Eric Campagne
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Université Paris-Cité, IJCLab, Orsay, France
| | - Mathilde Badoual
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Université Paris-Cité, IJCLab, Orsay, France
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10
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Meaney C, Das S, Colak E, Kohandel M. Deep learning characterization of brain tumours with diffusion weighted imaging. J Theor Biol 2023; 557:111342. [PMID: 36368560 DOI: 10.1016/j.jtbi.2022.111342] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
Glioblastoma multiforme (GBM) is one of the most deadly forms of cancer. Methods of characterizing these tumours are valuable for improving predictions of their progression and response to treatment. A mathematical model called the proliferation-invasion (PI) model has been used extensively in the literature to model the growth of these tumours, though it relies on known values of two key parameters: the tumour cell diffusivity and proliferation rate. Unfortunately, these parameters are difficult to estimate in a patient-specific manner, making personalized tumour forecasting challenging. In this paper, we develop and apply a deep learning model capable of making accurate estimates of these key GBM-characterizing parameters while simultaneously producing a full prediction of the tumour progression curve. Our method uses two sets of multi sequence MRI in order to produce estimations and relies on a preprocessing pipeline which includes brain tumour segmentation and conversion to tumour cellularity. We first apply our deep learning model to synthetic tumours to showcase the model's capabilities and identify situations where prediction errors are likely to occur. We then apply our model to a clinical dataset consisting of five patients diagnosed with GBM. For all patients, we derive evidence-based estimates for each of the PI model parameters and predictions for the future progression of the tumour, along with estimates of the parameter uncertainties. Our work provides a new, easily generalizable method for the estimation of patient-specific tumour parameters, which can be built upon to aid physicians in designing personalized treatments.
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Affiliation(s)
- Cameron Meaney
- Department of Applied Mathematics, University of Waterloo, Waterloo, Canada.
| | - Sunit Das
- Division of Neurosurgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Errol Colak
- Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Medical Imaging and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Odette Professorship in Artificial Intelligence for Medical Imaging, St. Michael's Hospital, Toronto, Canada
| | - Mohammad Kohandel
- Department of Applied Mathematics, University of Waterloo, Waterloo, Canada
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11
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Hormuth DA, Farhat M, Christenson C, Curl B, Chad Quarles C, Chung C, Yankeelov TE. Opportunities for improving brain cancer treatment outcomes through imaging-based mathematical modeling of the delivery of radiotherapy and immunotherapy. Adv Drug Deliv Rev 2022; 187:114367. [PMID: 35654212 PMCID: PMC11165420 DOI: 10.1016/j.addr.2022.114367] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/25/2022] [Accepted: 05/25/2022] [Indexed: 11/01/2022]
Abstract
Immunotherapy has become a fourth pillar in the treatment of brain tumors and, when combined with radiation therapy, may improve patient outcomes and reduce the neurotoxicity. As with other combination therapies, the identification of a treatment schedule that maximizes the synergistic effect of radiation- and immune-therapy is a fundamental challenge. Mechanism-based mathematical modeling is one promising approach to systematically investigate therapeutic combinations to maximize positive outcomes within a rigorous framework. However, successful clinical translation of model-generated combinations of treatment requires patient-specific data to allow the models to be meaningfully initialized and parameterized. Quantitative imaging techniques have emerged as a promising source of high quality, spatially and temporally resolved data for the development and validation of mathematical models. In this review, we will present approaches to personalize mechanism-based modeling frameworks with patient data, and then discuss how these techniques could be leveraged to improve brain cancer outcomes through patient-specific modeling and optimization of treatment strategies.
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Affiliation(s)
- David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA.
| | - Maguy Farhat
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77230, USA
| | - Chase Christenson
- Departments of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | - Brandon Curl
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77230, USA
| | - C Chad Quarles
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Caroline Chung
- Departments of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77230, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Diagnostic Medicine, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Oncology, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA; Departments of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77230, USA
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12
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Martens C, Rovai A, Bonatto D, Metens T, Debeir O, Decaestecker C, Goldman S, Van Simaeys G. Deep Learning for Reaction-Diffusion Glioma Growth Modeling: Towards a Fully Personalized Model? Cancers (Basel) 2022; 14:cancers14102530. [PMID: 35626134 PMCID: PMC9139770 DOI: 10.3390/cancers14102530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Mathematical tumor growth models have been proposed for decades to capture the growth of gliomas, an aggressive form of brain tumor. However, the estimation of the tumor cell-density distribution at diagnosis and model parameters from partial observations provided by magnetic resonance imaging are ill-posed problems. In this work, we propose a deep learning-based approach to address these problems. 1200 synthetic tumors are first generated using the mathematical model over brain geometries of 6 volunteers. Two deep convolutional neural networks are then trained to (i) reconstruct a whole tumor cell-density distribution and (ii) evaluate the model parameters from partial observations provided in the form of threshold-like imaging contours, with state-of-the-art results. From the estimated cell-density distribution and parameter values, the spatio-temporal evolution of the tumor can ultimately be accurately captured by the mathematical model. Such an approach could be of great interest for glioma characterization and therapy planning. Abstract Reaction-diffusion models have been proposed for decades to capture the growth of gliomas, the most common primary brain tumors. However, ill-posedness of the initialization at diagnosis time and parameter estimation of such models have restrained their clinical use as a personalized predictive tool. In this work, we investigate the ability of deep convolutional neural networks (DCNNs) to address commonly encountered pitfalls in the field. Based on 1200 synthetic tumors grown over real brain geometries derived from magnetic resonance (MR) data of six healthy subjects, we demonstrate the ability of DCNNs to reconstruct a whole tumor cell-density distribution from only two imaging contours at a single time point. With an additional imaging contour extracted at a prior time point, we also demonstrate the ability of DCNNs to accurately estimate the individual diffusivity and proliferation parameters of the model. From this knowledge, the spatio-temporal evolution of the tumor cell-density distribution at later time points can ultimately be precisely captured using the model. We finally show the applicability of our approach to MR data of a real glioblastoma patient. This approach may open the perspective of a clinical application of reaction-diffusion growth models for tumor prognosis and treatment planning.
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Affiliation(s)
- Corentin Martens
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
- Correspondence:
| | - Antonin Rovai
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
| | - Daniele Bonatto
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Thierry Metens
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
- Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Olivier Debeir
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Christine Decaestecker
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Serge Goldman
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
| | - Gaetan Van Simaeys
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
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13
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Häger W, Lazzeroni APM, Astaraki M, Toma-Dașu PI. CTV Delineation for High-Grade Gliomas: Is There Agreement With Tumor Cell Invasion Models? Adv Radiat Oncol 2022; 7:100987. [PMID: 35665308 PMCID: PMC9160672 DOI: 10.1016/j.adro.2022.100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022] Open
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14
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Harkos C, Svensson SF, Emblem KE, Stylianopoulos T. Inducing Biomechanical Heterogeneity in Brain Tumor Modeling by MR Elastography: Effects on Tumor Growth, Vascular Density and Delivery of Therapeutics. Cancers (Basel) 2022; 14:cancers14040884. [PMID: 35205632 PMCID: PMC8870149 DOI: 10.3390/cancers14040884] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Biomechanical forces aggravate brain tumor progression. In this study, magnetic resonance elastography (MRE) is employed to extract tissue biomechanical properties from five glioblastoma patients and a healthy subject, and data are incorporated in a mathematical model that simulates tumor growth. Mathematical modeling enables further understanding of glioblastoma development and allows patient-specific predictions for tumor vascularity and delivery of drugs. Incorporating MRE data results in a more realistic intratumoral distribution of mechanical stress and anisotropic tumor growth and a better description of subsequent events that are closely related to the development of stresses, including heterogeneity of the tumor vasculature and intrapatient variations in tumor perfusion and delivery of drugs. Abstract The purpose of this study is to develop a methodology that incorporates a more accurate assessment of tissue mechanical properties compared to current mathematical modeling by use of biomechanical data from magnetic resonance elastography. The elastography data were derived from five glioblastoma patients and a healthy subject and used in a model that simulates tumor growth, vascular changes due to mechanical stresses and delivery of therapeutic agents. The model investigates the effect of tumor-specific biomechanical properties on tumor anisotropic growth, vascular density heterogeneity and chemotherapy delivery. The results showed that including elastography data provides a more realistic distribution of the mechanical stresses in the tumor and induces anisotropic tumor growth. Solid stress distribution differs among patients, which, in turn, induces a distinct functional vascular density distribution—owing to the compression of tumor vessels—and intratumoral drug distribution for each patient. In conclusion, incorporating elastography data results in a more accurate calculation of intratumoral mechanical stresses and enables a better mathematical description of subsequent events, such as the heterogeneous development of the tumor vasculature and intrapatient variations in tumor perfusion and delivery of drugs.
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Affiliation(s)
- Constantinos Harkos
- Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia 1678, Cyprus;
| | - Siri Fløgstad Svensson
- Division of Radiology and Nuclear Medicine, Department of Diagnostic Physics, Oslo University Hospital, 0372 Oslo, Norway; (S.F.S.); (K.E.E.)
- Department of Physics, The Faculty of Mathematics and Natural Sciences, University of Oslo, 0371 Oslo, Norway
| | - Kyrre E. Emblem
- Division of Radiology and Nuclear Medicine, Department of Diagnostic Physics, Oslo University Hospital, 0372 Oslo, Norway; (S.F.S.); (K.E.E.)
| | - Triantafyllos Stylianopoulos
- Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia 1678, Cyprus;
- Correspondence:
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15
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Comparing the effects of linear and one-term Ogden elasticity in a model of glioblastoma invasion. BRAIN MULTIPHYSICS 2022. [DOI: 10.1016/j.brain.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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16
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Boruah D. Effect of energy requirements in the growth of brain tumor: a theoretical approach. Biomed Phys Eng Express 2021; 8. [PMID: 34654010 DOI: 10.1088/2057-1976/ac3056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/15/2021] [Indexed: 11/12/2022]
Abstract
A malignant tumor is an uncontrolled growth of tissues receiving energy in form of the nutrients provided by the microvascular networks. It is proposed that the supplied energy to a tumor is used for three purposes: the creation of new cells, maintenance of tumor cells, and tumor volume expansion by overcoming external pressure. A mathematical model studying the effects of energy required for maintenance and overcoming external pressure, the energy required creating a single cell, death rate, and tumor cell density on tumor development has been formulated. Including a term, residual energy for tumor growth in the tumor growth equation, the well-known logistic equation has been re-derived for tumors. Analytical solutions have been developed, and numerical analysis for the growth in brain tumors with the variation of parameters related to energy supply, the energy required for maintenance, and expansion of tumor has been performed. Expressions for the tumor growth rate(r) and carrying capacity(C) of the tumor are formulated in terms of the parameters used in the model. The range of 'r', estimated using our model is found within the ranges of tumor growth rates in gliomas reported by the other researchers. Selecting the model parameters precisely for a particular individual, the tumor growth rate and carrying capacity could be estimated accurately. Our study indicates that the actual growth rate and carrying capacity of a tumor reduce and tumor saturation time increases with the increase of death rate, the energy required for a single cell division, and energy requirement for the tumor cell maintenance.
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Affiliation(s)
- Dibyajyoti Boruah
- Department of Pathology, Armed Forces Medical College, Pune-411040 Maharashtra, India
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17
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Quantitative magnetic resonance imaging and tumor forecasting of breast cancer patients in the community setting. Nat Protoc 2021; 16:5309-5338. [PMID: 34552262 PMCID: PMC9753909 DOI: 10.1038/s41596-021-00617-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
This protocol describes a complete data acquisition, analysis and computational forecasting pipeline for employing quantitative MRI data to predict the response of locally advanced breast cancer to neoadjuvant therapy in a community-based care setting. The methodology has previously been successfully applied to a heterogeneous patient population. The protocol details how to acquire the necessary images followed by registration, segmentation, quantitative perfusion and diffusion analysis, model calibration, and prediction. The data collection portion of the protocol requires ~25 min of scanning, postprocessing requires 2-3 h, and the model calibration and prediction components require ~10 h per patient depending on tumor size. The response of individual breast cancer patients to neoadjuvant therapy is forecast by application of a biophysical, reaction-diffusion mathematical model to these data. Successful application of the protocol results in coregistered MRI data from at least two scan visits that quantifies an individual tumor's size, cellularity and vascular properties. This enables a spatially resolved prediction of how a particular patient's tumor will respond to therapy. Expertise in image acquisition and analysis, as well as the numerical solution of partial differential equations, is required to carry out this protocol.
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18
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Improving cancer treatments via dynamical biophysical models. Phys Life Rev 2021; 39:1-48. [PMID: 34688561 DOI: 10.1016/j.plrev.2021.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022]
Abstract
Despite significant advances in oncological research, cancer nowadays remains one of the main causes of mortality and morbidity worldwide. New treatment techniques, as a rule, have limited efficacy, target only a narrow range of oncological diseases, and have limited availability to the general public due their high cost. An important goal in oncology is thus the modification of the types of antitumor therapy and their combinations, that are already introduced into clinical practice, with the goal of increasing the overall treatment efficacy. One option to achieve this goal is optimization of the schedules of drugs administration or performing other medical actions. Several factors complicate such tasks: the adverse effects of treatments on healthy cell populations, which must be kept tolerable; the emergence of drug resistance due to the intrinsic plasticity of heterogeneous cancer cell populations; the interplay between different types of therapies administered simultaneously. Mathematical modeling, in which a tumor and its microenvironment are considered as a single complex system, can address this complexity and can indicate potentially effective protocols, that would require experimental verification. In this review, we consider classical methods, current trends and future prospects in the field of mathematical modeling of tumor growth and treatment. In particular, methods of treatment optimization are discussed with several examples of specific problems related to different types of treatment.
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19
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Adenis L, Plaszczynski S, Grammaticos B, Pallud J, Badoual M. The Effect of Radiotherapy on Diffuse Low-Grade Gliomas Evolution: Confronting Theory with Clinical Data. J Pers Med 2021; 11:jpm11080818. [PMID: 34442462 PMCID: PMC8401413 DOI: 10.3390/jpm11080818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/21/2022] Open
Abstract
Diffuse low-grade gliomas are slowly growing tumors that always recur after treatment. In this paper, we revisit the modeling of the evolution of the tumor radius before and after the radiotherapy process and propose a novel model that is simple yet biologically motivated and that remedies some shortcomings of previously proposed ones. We confront this with clinical data consisting of time series of tumor radii from 43 patient records by using a stochastic optimization technique and obtain very good fits in all cases. Since our model describes the evolution of a tumor from the very first glioma cell, it gives access to the possible age of the tumor. Using the technique of profile likelihood to extract all of the information from the data, we build confidence intervals for the tumor birth age and confirm the fact that low-grade gliomas seem to appear in the late teenage years. Moreover, an approximate analytical expression of the temporal evolution of the tumor radius allows us to explain the correlations observed in the data.
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Affiliation(s)
- Léo Adenis
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, 91405 Orsay, France; (L.A.); (B.G.); (M.B.)
- IJCLab, Université de Paris, 91405 Orsay, France
| | - Stéphane Plaszczynski
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, 91405 Orsay, France; (L.A.); (B.G.); (M.B.)
- IJCLab, Université de Paris, 91405 Orsay, France
- Correspondence:
| | - Basile Grammaticos
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, 91405 Orsay, France; (L.A.); (B.G.); (M.B.)
- IJCLab, Université de Paris, 91405 Orsay, France
| | - Johan Pallud
- Department of Neurosurgery, GHU Paris, Sainte-Anne Hospital, 75014 Paris, France;
- Université de Paris, Sorbonne Paris Cité, 75014 Paris, France
- Inserm, U1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, 75014 Paris, France
| | - Mathilde Badoual
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, 91405 Orsay, France; (L.A.); (B.G.); (M.B.)
- IJCLab, Université de Paris, 91405 Orsay, France
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20
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Pang L, Liu S, Zhao Z, Song X, Zhang X, Tian T. Kinetic modeling and numerical simulations to predict patient-specific responses to radiotherapy. INT J BIOMATH 2021. [DOI: 10.1142/s1793524521500832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recent research indicates that quiescent tumor cells are significantly less radiosensitive with a greater repair capacity than proliferative cells. In order to better predict patient-specific responses to radiotherapy, we develop a mathematical model with treatment terms to describe dynamical behaviors of tumor growth. The global stabilities of the tumor-free equilibrium, the tumor-present equilibrium and the corresponding sufficient criteria are obtained. In addition, we simulate volumetric imaging data from 12 head-and-neck cancer patients and estimate the patient-specific responses to radiotherapy. Results indicate that radiosensitivity of proliferative cells is a critical factor that determines a successful radiotherapy. By comparison with previous simulation results, we find that the model presented in this paper is more suitable to describe the radiotherapy procedure of head-and-neck cancer. Finally, we discuss the influences of different radiotherapy strategies on therapeutic effect. The results show that treatment strategies with large dose or short treatment cycle can obtain better treatment effect.
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Affiliation(s)
- Liuyong Pang
- School of Mathematics and Statistics, Huanghuai University, Zhumadian 463000, P. R. China
| | - Sanhong Liu
- School of Mathematics and Statistics, Hubei University of Science and Technology, Xianning 437100, P. R. China
| | - Zhong Zhao
- School of Mathematics and Statistics, Huanghuai University, Zhumadian 463000, P. R. China
| | - XinYu Song
- School of Mathematics and Statistics, Huanghuai University, Zhumadian 463000, P. R. China
| | - Xinan Zhang
- School of Mathematics and Statistics, Central China Normal University, Wuhan 430079, P. R. China
| | - Tianhai Tian
- School of Mathematical Sciences, Monash University, Melbourne, Vic 3800, Australia
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21
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Bolcaen J, Kleynhans J, Nair S, Verhoeven J, Goethals I, Sathekge M, Vandevoorde C, Ebenhan T. A perspective on the radiopharmaceutical requirements for imaging and therapy of glioblastoma. Theranostics 2021; 11:7911-7947. [PMID: 34335972 PMCID: PMC8315062 DOI: 10.7150/thno.56639] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/29/2021] [Indexed: 11/26/2022] Open
Abstract
Despite numerous clinical trials and pre-clinical developments, the treatment of glioblastoma (GB) remains a challenge. The current survival rate of GB averages one year, even with an optimal standard of care. However, the future promises efficient patient-tailored treatments, including targeted radionuclide therapy (TRT). Advances in radiopharmaceutical development have unlocked the possibility to assess disease at the molecular level allowing individual diagnosis. This leads to the possibility of choosing a tailored, targeted approach for therapeutic modalities. Therapeutic modalities based on radiopharmaceuticals are an exciting development with great potential to promote a personalised approach to medicine. However, an effective targeted radionuclide therapy (TRT) for the treatment of GB entails caveats and requisites. This review provides an overview of existing nuclear imaging and TRT strategies for GB. A critical discussion of the optimal characteristics for new GB targeting therapeutic radiopharmaceuticals and clinical indications are provided. Considerations for target selection are discussed, i.e. specific presence of the target, expression level and pharmacological access to the target, with particular attention to blood-brain barrier crossing. An overview of the most promising radionuclides is given along with a validation of the relevant radiopharmaceuticals and theranostic agents (based on small molecules, peptides and monoclonal antibodies). Moreover, toxicity issues and safety pharmacology aspects will be presented, both in general and for the brain in particular.
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Affiliation(s)
- Julie Bolcaen
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | - Janke Kleynhans
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Shankari Nair
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | | | - Ingeborg Goethals
- Ghent University Hospital, Department of Nuclear Medicine, Ghent, Belgium
| | - Mike Sathekge
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Charlot Vandevoorde
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | - Thomas Ebenhan
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria, Pretoria, South Africa
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22
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Falco J, Agosti A, Vetrano IG, Bizzi A, Restelli F, Broggi M, Schiariti M, DiMeco F, Ferroli P, Ciarletta P, Acerbi F. In Silico Mathematical Modelling for Glioblastoma: A Critical Review and a Patient-Specific Case. J Clin Med 2021; 10:2169. [PMID: 34067871 PMCID: PMC8156762 DOI: 10.3390/jcm10102169] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/24/2021] [Accepted: 05/14/2021] [Indexed: 01/28/2023] Open
Abstract
Glioblastoma extensively infiltrates the brain; despite surgery and aggressive therapies, the prognosis is poor. A multidisciplinary approach combining mathematical, clinical and radiological data has the potential to foster our understanding of glioblastoma evolution in every single patient, with the aim of tailoring therapeutic weapons. In particular, the ultimate goal of biomathematics for cancer is the identification of the most suitable theoretical models and simulation tools, both to describe the biological complexity of carcinogenesis and to predict tumor evolution. In this report, we describe the results of a critical review about different mathematical models in neuro-oncology with their clinical implications. A comprehensive literature search and review for English-language articles concerning mathematical modelling in glioblastoma has been conducted. The review explored the different proposed models, classifying them and indicating the significative advances of each one. Furthermore, we present a specific case of a glioblastoma patient in which our recently proposed innovative mechanical model has been applied. The results of the mathematical models have the potential to provide a relevant benefit for clinicians and, more importantly, they might drive progress towards improving tumor control and patient's prognosis. Further prospective comparative trials, however, are still necessary to prove the impact of mathematical neuro-oncology in clinical practice.
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Affiliation(s)
- Jacopo Falco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Abramo Agosti
- MOX, Department of Mathematics, Politecnico di Milano, 20133 Milan, Italy; (A.A.); (P.C.)
| | - Ignazio G. Vetrano
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Alberto Bizzi
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy;
| | - Francesco Restelli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Morgan Broggi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Marco Schiariti
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
- Department of Neurological Surgery, Johns Hopkins Medical School, Baltimora, MD 21205, USA
| | - Paolo Ferroli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
| | - Pasquale Ciarletta
- MOX, Department of Mathematics, Politecnico di Milano, 20133 Milan, Italy; (A.A.); (P.C.)
| | - Francesco Acerbi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (J.F.); (I.G.V.); (F.R.); (M.B.); (M.S.); (F.D.); (P.F.)
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23
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Hormuth DA, Al Feghali KA, Elliott AM, Yankeelov TE, Chung C. Image-based personalization of computational models for predicting response of high-grade glioma to chemoradiation. Sci Rep 2021; 11:8520. [PMID: 33875739 PMCID: PMC8055874 DOI: 10.1038/s41598-021-87887-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/30/2021] [Indexed: 12/16/2022] Open
Abstract
High-grade gliomas are an aggressive and invasive malignancy which are susceptible to treatment resistance due to heterogeneity in intratumoral properties such as cell proliferation and density and perfusion. Non-invasive imaging approaches can measure these properties, which can then be used to calibrate patient-specific mathematical models of tumor growth and response. We employed multiparametric magnetic resonance imaging (MRI) to identify tumor extent (via contrast-enhanced T1-weighted, and T2-FLAIR) and capture intratumoral heterogeneity in cell density (via diffusion-weighted imaging) to calibrate a family of mathematical models of chemoradiation response in nine patients with unresected or partially resected disease. The calibrated model parameters were used to forecast spatially-mapped individual tumor response at future imaging visits. We then employed the Akaike information criteria to select the most parsimonious member from the family, a novel two-species model describing the enhancing and non-enhancing components of the tumor. Using this model, we achieved low error in predictions of the enhancing volume (median: - 2.5%, interquartile range: 10.0%) and a strong correlation in total cell count (Kendall correlation coefficient 0.79) at 3-months post-treatment. These preliminary results demonstrate the plausibility of using multiparametric MRI data to inform spatially-informative, biologically-based predictive models of tumor response in the setting of clinical high-grade gliomas.
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Affiliation(s)
- David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA.
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, Austin, TX, USA.
| | - Karine A Al Feghali
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew M Elliott
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Austin, TX, USA
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, Austin, TX, USA
- Department of Oncology, The University of Texas at Austin, Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, Austin, TX, USA
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
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Kumar P, Li J, Surulescu C. Multiscale modeling of glioma pseudopalisades: contributions from the tumor microenvironment. J Math Biol 2021; 82:49. [PMID: 33846838 PMCID: PMC8041715 DOI: 10.1007/s00285-021-01599-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/20/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022]
Abstract
Gliomas are primary brain tumors with a high invasive potential and infiltrative spread. Among them, glioblastoma multiforme (GBM) exhibits microvascular hyperplasia and pronounced necrosis triggered by hypoxia. Histological samples showing garland-like hypercellular structures (so-called pseudopalisades) centered around the occlusion site of a capillary are typical for GBM and hint on poor prognosis of patient survival. We propose a multiscale modeling approach in the kinetic theory of active particles framework and deduce by an upscaling process a reaction-diffusion model with repellent pH-taxis. We prove existence of a unique global bounded classical solution for a version of the obtained macroscopic system and investigate the asymptotic behavior of the solution. Moreover, we study two different types of scaling and compare the behavior of the obtained macroscopic PDEs by way of simulations. These show that patterns (not necessarily of Turing type), including pseudopalisades, can be formed for some parameter ranges, in accordance with the tumor grade. This is true when the PDEs are obtained via parabolic scaling (undirected tissue), while no such patterns are observed for the PDEs arising by a hyperbolic limit (directed tissue). This suggests that brain tissue might be undirected - at least as far as glioma migration is concerned. We also investigate two different ways of including cell level descriptions of response to hypoxia and the way they are related .
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Affiliation(s)
- Pawan Kumar
- TU Kaiserslautern, Felix-Klein-Zentrum für Mathematik, Paul-Ehrlich-Street 31, 67663, Kaiserslautern, Germany
| | - Jing Li
- College of Science, Minzu University of China, Beijing, 100081, People's Republic of China
| | - Christina Surulescu
- TU Kaiserslautern, Felix-Klein-Zentrum für Mathematik, Paul-Ehrlich-Street 31, 67663, Kaiserslautern, Germany.
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Hormuth DA, Jarrett AM, Davis T, Yankeelov TE. Towards an Image-Informed Mathematical Model of In Vivo Response to Fractionated Radiation Therapy. Cancers (Basel) 2021; 13:cancers13081765. [PMID: 33917080 PMCID: PMC8067722 DOI: 10.3390/cancers13081765] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Using medical imaging data and computational models, we develop a modeling framework to provide personalized treatment response forecasts to fractionated radiation therapy for individual tumors. We evaluate this approach in an animal model of brain cancer and forecast changes in tumor cellularity and vasculature. Abstract Fractionated radiation therapy is central to the treatment of numerous malignancies, including high-grade gliomas where complete surgical resection is often impractical due to its highly invasive nature. Development of approaches to forecast response to fractionated radiation therapy may provide the ability to optimize or adapt treatment plans for radiotherapy. Towards this end, we have developed a family of 18 biologically-based mathematical models describing the response of both tumor and vasculature to fractionated radiation therapy. Importantly, these models can be personalized for individual tumors via quantitative imaging measurements. To evaluate this family of models, rats (n = 7) with U-87 glioblastomas were imaged with magnetic resonance imaging (MRI) before, during, and after treatment with fractionated radiotherapy (with doses of either 2 Gy/day or 4 Gy/day for up to 10 days). Estimates of tumor and blood volume fractions, provided by diffusion-weighted MRI and dynamic contrast-enhanced MRI, respectively, were used to calibrate tumor-specific model parameters. The Akaike Information Criterion was employed to select the most parsimonious model and determine an ensemble averaged model, and the resulting forecasts were evaluated at the global and local level. At the global level, the selected model’s forecast resulted in less than 16.2% error in tumor volume estimates. At the local (voxel) level, the median Pearson correlation coefficient across all prediction time points ranged from 0.57 to 0.87 for all animals. While the ensemble average forecast resulted in increased error (ranging from 4.0% to 1063%) in tumor volume predictions over the selected model, it increased the voxel wise correlation (by greater than 12.3%) for three of the animals. This study demonstrates the feasibility of calibrating a model of response by serial quantitative MRI data collected during fractionated radiotherapy to predict response at the conclusion of treatment.
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Affiliation(s)
- David A. Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
- Correspondence:
| | - Angela M. Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
| | - Tessa Davis
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Thomas E. Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA;
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Oncology, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Sosa-Marrero C, de Crevoisier R, Hernandez A, Fontaine P, Rioux-Leclercq N, Mathieu R, Fautrel A, Paris F, Acosta O. Towards a Reduced In Silico Model Predicting Biochemical Recurrence After Radiotherapy in Prostate Cancer. IEEE Trans Biomed Eng 2021; 68:2718-2729. [PMID: 33460366 DOI: 10.1109/tbme.2021.3052345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Purposes of this work were i) to develop an in silico model of tumor response to radiotherapy, ii) to perform an exhaustive sensitivity analysis in order to iii) propose a simplified version and iv) to predict biochemical recurrence with both the comprehensive and the reduced model. METHODS A multiscale computational model of tumor response to radiotherapy was developed. It integrated the following radiobiological mechanisms: oxygenation, including hypoxic death; division of tumor cells; VEGF diffusion driving angiogenesis; division of healthy cells and oxygen-dependent response to irradiation, considering, cycle arrest and mitotic catastrophe. A thorough sensitivity analysis using the Morris screening method was performed on 21 prostate computational tissues. Tumor control probability (TCP) curves of the comprehensive model and 15 reduced versions were compared. Logistic regression was performed to predict biochemical recurrence after radiotherapy on 76 localized prostate cancer patients using an output of the comprehensive and the reduced models. RESULTS No significant difference was found between the TCP curves of the comprehensive and a simplified version which only considered oxygenation, division of tumor cells and their response to irradiation. Biochemical recurrence predictions using the comprehensive and the reduced models improved those made from pre-treatment imaging parameters (AUC = 0.81 ± 0.02 and 0.82 ± 0.02 vs. 0.75 ± 0.03, respectively). CONCLUSION A reduced model of tumor response to radiotherapy able to predict biochemical recurrence in prostate cancer was obtained. SIGNIFICANCE This reduced model may be used in the future to optimize personalized fractionation schedules.
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Bando M, Tsunoyama Y, Suzuki K, Toki H. WAM to SeeSaw model for cancer therapy - overcoming LQM difficulties. Int J Radiat Biol 2020; 97:228-239. [PMID: 33253050 DOI: 10.1080/09553002.2021.1854487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The assessment of biological effects caused by radiation exposure has been currently carried out with the linear-quadratic (LQ) model as an extension of the linear non-threshold (LNT) model. In this study, we suggest a new mathematical model named as SeaSaw (SS) model, which describes proliferation and cell death effects by taking account of Bergonie-Tribondeau's law in terms of a differential equation in time. We show how this model overcomes the long-standing difficulties of the LQ model. MATERIALS AND METHODS We construct the SS model as an extended Wack-A-Mole (WAM) model by using a differential equation with respect to time in order to express the dynamics of the proliferation effect. A large number of accumulated data of such parameters as α and β in the LQ based models provide us with valuable pieces of information on the corresponding parameter b 1 and the maximum volume V m of the SS model. The dose rate b 1 and the notion of active cell can explain the present data without introduction of β, which is obtained by comparing the SS model with not only the cancer therapy data but also with in vitro experimental data. Numerical calculations are presented to grasp the global features of the SS model. RESULTS The SS model predicts the time dependence of the number of active- and inactive-cells. The SS model clarifies how the effect of radiation depends on the cancer stage at the starting time in the treatment. Further, the time dependence of the tumor volume is calculated by changing individual dose strength, which results in the change of the irradiation duration for the same effect. We can consider continuous irradiation in the SS model with interesting outcome on the time dependence of the tumor volume for various dose rates. Especially by choosing the value of the dose rate to be balanced with the total growth rate, the tumor volume is kept constant. CONCLUSIONS The SS model gives a simple equation to study the situation of clinical radiation therapy and risk estimation of radiation. The radiation parameter extracted from the cancer therapy is close to the value obtained from animal experiment in vitro and in vivo. We expect the SS model leads us to a unified description of radiation therapy and protection and provides a great development in cancer-therapy clinical-planning.
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Affiliation(s)
- Masako Bando
- Research Center for Nuclear Physics, Osaka University, Osaka, Japan
| | - Yuichi Tsunoyama
- Radioisotope Research Center, Agency for Health, Safety and Environment, Kyoto University, Kyoto, Japan
| | - Kazuyo Suzuki
- Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Hiroshi Toki
- Research Center for Nuclear Physics, Osaka University, Osaka, Japan
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28
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Ayensa-Jiménez J, Pérez-Aliacar M, Randelovic T, Oliván S, Fernández L, Sanz-Herrera JA, Ochoa I, Doweidar MH, Doblaré M. Mathematical formulation and parametric analysis of in vitro cell models in microfluidic devices: application to different stages of glioblastoma evolution. Sci Rep 2020; 10:21193. [PMID: 33273574 PMCID: PMC7713081 DOI: 10.1038/s41598-020-78215-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/26/2020] [Indexed: 12/31/2022] Open
Abstract
In silico models and computer simulation are invaluable tools to better understand complex biological processes such as cancer evolution. However, the complexity of the biological environment, with many cell mechanisms in response to changing physical and chemical external stimuli, makes the associated mathematical models highly non-linear and multiparametric. One of the main problems of these models is the determination of the parameters’ values, which are usually fitted for specific conditions, making the conclusions drawn difficult to generalise. We analyse here an important biological problem: the evolution of hypoxia-driven migratory structures in Glioblastoma Multiforme (GBM), the most aggressive and lethal primary brain tumour. We establish a mathematical model considering the interaction of the tumour cells with oxygen concentration in what is called the go or grow paradigm. We reproduce in this work three different experiments, showing the main GBM structures (pseudopalisade and necrotic core formation), only changing the initial and boundary conditions. We prove that it is possible to obtain versatile mathematical tools which, together with a sound parametric analysis, allow to explain complex biological phenomena. We show the utility of this hybrid “biomimetic in vitro-in silico” platform to help to elucidate the mechanisms involved in cancer processes, to better understand the role of the different phenomena, to test new scientific hypotheses and to design new data-driven experiments.
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Affiliation(s)
- Jacobo Ayensa-Jiménez
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Marina Pérez-Aliacar
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Teodora Randelovic
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Sara Oliván
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Luis Fernández
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - José Antonio Sanz-Herrera
- School of Engineering, Department of Mechanics of Continuous Media and Theory of Structures, University of Seville, Camino de los descubrimientos, s/n, 41092, Sevilla, Spain
| | - Ignacio Ochoa
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Mohamed H Doweidar
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain.,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Manuel Doblaré
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Mariano Esquillor s/n, 50018, Zaragoza, Spain. .,Institute for Health Research Aragón (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain. .,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029, Madrid, Spain.
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29
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Jarrett AM, Hormuth DA, Wu C, Kazerouni AS, Ekrut DA, Virostko J, Sorace AG, DiCarlo JC, Kowalski J, Patt D, Goodgame B, Avery S, Yankeelov TE. Evaluating patient-specific neoadjuvant regimens for breast cancer via a mathematical model constrained by quantitative magnetic resonance imaging data. Neoplasia 2020; 22:820-830. [PMID: 33197744 PMCID: PMC7677708 DOI: 10.1016/j.neo.2020.10.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
The ability to accurately predict response and then rigorously optimize a therapeutic regimen on a patient-specific basis, would transform oncology. Toward this end, we have developed an experimental-mathematical framework that integrates quantitative magnetic resonance imaging (MRI) data into a biophysical model to predict patient-specific treatment response of locally advanced breast cancer to neoadjuvant therapy. Diffusion-weighted and dynamic contrast-enhanced MRI data is collected prior to therapy, after 1 cycle of therapy, and at the completion of the first therapeutic regimen. The model is initialized and calibrated with the first 2 patient-specific MRI data sets to predict response at the third, which is then compared to patient outcomes (N = 18). The model's predictions for total cellularity, total volume, and the longest axis at the completion of the regimen are significant within expected measurement precision (P< 0.05) and strongly correlated with measured response (P < 0.01). Further, we use the model to investigate, in silico, a range of (practical) alternative treatment plans to achieve the greatest possible tumor control for each individual in a subgroup of patients (N = 13). The model identifies alternative dosing strategies predicted to achieve greater tumor control compared to the standard of care for 12 of 13 patients (P < 0.01). In summary, a predictive, mechanism-based mathematical model has demonstrated the ability to identify alternative treatment regimens that are forecasted to outperform the therapeutic regimens the patients clinically. This has important implications for clinical trial design with the opportunity to alter oncology care in the future.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA
| | - Chengyue Wu
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Anum S Kazerouni
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - David A Ekrut
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - John Virostko
- Livestrong Cancer Institutes, Austin, TX, USA; Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julie C DiCarlo
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - Jeanne Kowalski
- Livestrong Cancer Institutes, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA
| | | | - Boone Goodgame
- Department of Oncology, The University of Texas at Austin, Austin, TX, USA; Department of Internal Medicine, The University of Texas at Austin, Austin, TX, USA; Seton Hospital, Austin, TX, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA; Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA; Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA; Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA.
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30
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Jarrett AM, Hormuth DA, Adhikarla V, Sahoo P, Abler D, Tumyan L, Schmolze D, Mortimer J, Rockne RC, Yankeelov TE. Towards integration of 64Cu-DOTA-trastuzumab PET-CT and MRI with mathematical modeling to predict response to neoadjuvant therapy in HER2 + breast cancer. Sci Rep 2020; 10:20518. [PMID: 33239688 PMCID: PMC7688955 DOI: 10.1038/s41598-020-77397-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
While targeted therapies exist for human epidermal growth factor receptor 2 positive (HER2 +) breast cancer, HER2 + patients do not always respond to therapy. We present the results of utilizing a biophysical mathematical model to predict tumor response for two HER2 + breast cancer patients treated with the same therapeutic regimen but who achieved different treatment outcomes. Quantitative data from magnetic resonance imaging (MRI) and 64Cu-DOTA-trastuzumab positron emission tomography (PET) are used to estimate tumor density, perfusion, and distribution of HER2-targeted antibodies for each individual patient. MRI and PET data are collected prior to therapy, and follow-up MRI scans are acquired at a midpoint in therapy. Given these data types, we align the data sets to a common image space to enable model calibration. Once the model is parameterized with these data, we forecast treatment response with and without HER2-targeted therapy. By incorporating targeted therapy into the model, the resulting predictions are able to distinguish between the two different patient responses, increasing the difference in tumor volume change between the two patients by > 40%. This work provides a proof-of-concept strategy for processing and integrating PET and MRI modalities into a predictive, clinical-mathematical framework to provide patient-specific predictions of HER2 + treatment response.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - Vikram Adhikarla
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
| | - Prativa Sahoo
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
| | - Daniel Abler
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lusine Tumyan
- Department of Radiology, City of Hope National Medical Center, Duarte, CA, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Joanne Mortimer
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA.
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA.
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA.
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA.
- Department of Oncology, The University of Texas at Austin, Austin, TX, USA.
- Department of Biomedical Engineering, The University of Texas at Austin, 107 W Dean Keeton Street Stop C0800, Austin, TX, 78712, USA.
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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31
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Kashef A, Khatibi T, Mehrvar A. Prediction of Cranial Radiotherapy Treatment in Pediatric Acute Lymphoblastic Leukemia Patients Using Machine Learning: A Case Study at MAHAK Hospital. Asian Pac J Cancer Prev 2020; 21:3211-3219. [PMID: 33247677 PMCID: PMC8033115 DOI: 10.31557/apjcp.2020.21.11.3211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Acute Lymphoblastic Leukemia (ALL) is the most common blood disease in children and is responsible for the most deaths amongst children. Due to major improvements in the treatment protocols in the 50-years period, the survivability of this disease has witnessed dramatic rise until this date which is about 90 percent. There are many investigations tending to indicate the efficiency of cranial radiotherapy found out that without that, outcome of the patients did not change and even it improved at some cases. Methods: the main aim of this study is predicting cranial radiotherapy treatment in pediatric acute lymphoblastic leukemia patients using machine learning. Scope of this paper is intertwined with predicting the necessity of one of the treatment modalities that has been used for many years for this group of patients named Cranial Radiotherapy (CRT). For this purpose, a case study is considered at Mahak charity hospital. In this paper, our focus is on ALL patients aged 0 to 17 treated at Mahak hospital, one of the best centers for treatment of childhood malignancies in Iran. Dataset analyzed in this study is gathered by the research team from patient’s paper-based files. Our dataset consists of 241 observations on patients with 31 attributes after the data cleaning process. Our designed machine learning model for predicting cranial radiotherapy treatment in pediatric acute lymphoblastic leukemia patients is a stacked ensemble classifier of independently strong models with a meta-learner to tune the weights and parameters of the base classifiers. Results: The stacked ensemble classifier show highly reasonable performance with AUC of 87.52%. Moreover, the attributes are ranked based on their predictive power and the most important variable for CRT necessity prediction is the disease relapse. Conclusion: In order to conclude, derived from previous studies regarding CRT it is not only cost-effective but also more healthy to eradicate the use of CRT for the treatment of childhood ALL. Furthermore, it is valuable to increase the clinical databases by creating more synthetic health databases not only for research purposes but also for physicians to keep track of their patient’s status.
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Affiliation(s)
- Amirarash Kashef
- School of Industrial and Systems Engineering, Tarbiat Modares University (TMU), Tehran, Iran
| | - Toktam Khatibi
- School of Industrial and Systems Engineering, Tarbiat Modares University (TMU), Tehran, Iran
| | - Azim Mehrvar
- Mahak Hematology Oncology Research Center (Mahak-HORC), Mahak Hospital, Tehran, Iran.,AJA Cancer Epidemiology Research and Treatment Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran
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32
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Bayesian Information-Theoretic Calibration of Radiotherapy Sensitivity Parameters for Informing Effective Scanning Protocols in Cancer. J Clin Med 2020; 9:jcm9103208. [PMID: 33027933 PMCID: PMC7601810 DOI: 10.3390/jcm9103208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 12/03/2022] Open
Abstract
With new advancements in technology, it is now possible to collect data for a variety of different metrics describing tumor growth, including tumor volume, composition, and vascularity, among others. For any proposed model of tumor growth and treatment, we observe large variability among individual patients’ parameter values, particularly those relating to treatment response; thus, exploiting the use of these various metrics for model calibration can be helpful to infer such patient-specific parameters both accurately and early, so that treatment protocols can be adjusted mid-course for maximum efficacy. However, taking measurements can be costly and invasive, limiting clinicians to a sparse collection schedule. As such, the determination of optimal times and metrics for which to collect data in order to best inform proper treatment protocols could be of great assistance to clinicians. In this investigation, we employ a Bayesian information-theoretic calibration protocol for experimental design in order to identify the optimal times at which to collect data for informing treatment parameters. Within this procedure, data collection times are chosen sequentially to maximize the reduction in parameter uncertainty with each added measurement, ensuring that a budget of n high-fidelity experimental measurements results in maximum information gain about the low-fidelity model parameter values. In addition to investigating the optimal temporal pattern for data collection, we also develop a framework for deciding which metrics should be utilized at each data collection point. We illustrate this framework with a variety of toy examples, each utilizing a radiotherapy treatment regimen. For each scenario, we analyze the dependence of the predictive power of the low-fidelity model upon the measurement budget.
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Dehghan M, Narimani N. Radial basis function-generated finite difference scheme for simulating the brain cancer growth model under radiotherapy in various types of computational domains. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 195:105641. [PMID: 32726719 DOI: 10.1016/j.cmpb.2020.105641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVES We extend the original mathematical model, i.e., Swanson's reaction-diffusion equation to the surfaces with no boundary, and we find a new numerical method based on a meshless approach for solving numerically Swanson's reaction-diffusion model in the square and on the sphere. METHODS To solve numerically the Swanson's reaction-diffusion model and its extension version, a collocation meshless technique, namely radial basis function-generated finite difference (RBF-FD) scheme is employed for approximating the spatial variables in the square domain and on the sphere, respectively. Also, to approximate the time variable of the studied models, a first-order semi-implicit backward Euler scheme is used. The resulting fully discrete scheme is a linear system of algebraic equations per time step that is solved via the biconjugate gradient stabilized (BiCGSTAB) iterative algorithm with a zero-fill incomplete lower-upper (ILU) preconditioner. RESULTS The numerical simulations show the growth of untreated and treated brain tumors with radiotherapy using estimated and clinical data (given from magnetic resonance imaging (MRI) scans of patients). Moreover, the results reported here can be used for improving the treatment strategies of the invasive brain tumor. CONCLUSIONS Using the developed numerical scheme in this paper, we can simulate the behavior of the invasive form of brain tumor response to radiotherapy. Also, we can see the effects of radiation response on the brain tumor cell concentration of individual patients. The proposed meshless technique, which is applied for solving numerically the studied model, does not depend on any background mesh or triangulation for approximation in comparison with mesh-dependent methods. Moreover, we apply this technique to the sphere via any set of distributed points easily.
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Affiliation(s)
- Mehdi Dehghan
- Department of Applied Mathematics, Faculty of Mathematics and Computer Sciences, Amirkabir University of Technology, No. 424, Hafez Ave., Tehran, 15914, Iran.
| | - Niusha Narimani
- Department of Applied Mathematics, Faculty of Mathematics and Computer Sciences, Amirkabir University of Technology, No. 424, Hafez Ave., Tehran, 15914, Iran.
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Ebrahimi Zade A, Shahabi Haghighi S, Soltani M. Reinforcement learning for optimal scheduling of Glioblastoma treatment with Temozolomide. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 193:105443. [PMID: 32311510 DOI: 10.1016/j.cmpb.2020.105443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/17/2020] [Accepted: 03/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Glioblastoma multiforme (GBM) is the most frequent primary brain tumor in adults and Temozolomide (TMZ) is an effective chemotherapeutic agent for its treatment. In Silico models of GBM growth provide an appropriate foundation for analysis and comparison of different regimens. We propose a mathematical frame for patient specific design of optimal chemotherapy regimens for GBM patients. METHODS The proposed frame includes online interaction of a virtual GBM with an optimizing agent. Spatiotemporal dynamics of GBM growth and its response to TMZ are simulated with a three dimensional hybrid cellular automaton. Q learning is tailored to the virtual GBM for treatment optimization aimed at minimizing tumor size at the end of treatment course. Q learning consists of a learning agent that interacts with the virtual GBM. System state is affected by the agent decisions and the obtained rewards guide Q learning to the optimal schedule. RESULTS Computational results confirm that the optimal chemotherapy schedule depends on some patient specific parameters including body weight, tumor size and its position in the brain. Furthermore, the algorithm is used for scheduling 2100 mg of TMZ on a virtual GBM and the obtained schedule is to administer150 mg of TMZ every other day. The obtained schedule is compared to the standard 7/14 regimen and the results show that it is superior to the 7/14 regimen in minimizing tumor size. CONCLUSION The proposed frame is an appropriate decision support system for patient specific design of TMZ administration regimens on GBM patients. Also, since the obtained optimal schedule outperforms the standard 7/14 regimen, it is worthy of further clinical testing.
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Affiliation(s)
- Amir Ebrahimi Zade
- Faculty of Industrial Engineering and Systems Management, Amirkabir University of Technology, Tehran, Iran
| | | | - Madjid Soltani
- Faculty of Mechanical Engineering, K.N. Toosi University of Technology, Tehran 1969764499, Iran; Advanced Bioengineering Initiative Center, Computational Medicine Center, K. N. Toosi University of Technology, Tehran, Iran; Centre for Biotechnology and Bioengineering (CBB), University of Waterloo, Waterloo, ON, Canada; Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON, Canada
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Dahlman EL, Watanabe Y. Evaluating the biologically effective dose (BED) concept using a dynamic tumor simulation model. Med Phys 2020; 47:3710-3720. [DOI: 10.1002/mp.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Erik L. Dahlman
- Department of Radiation Oncology University of Minnesota MMC 494 Mayo 8494A 420 Delaware St, SE Minneapolis MN55455USA
| | - Yoichi Watanabe
- Department of Radiation Oncology University of Minnesota MMC 494 Mayo 8494A 420 Delaware St, SE Minneapolis MN55455USA
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36
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Optimization of Dose Fractionation for Radiotherapy of a Solid Tumor with Account of Oxygen Effect and Proliferative Heterogeneity. MATHEMATICS 2020. [DOI: 10.3390/math8081204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A spatially-distributed continuous mathematical model of solid tumor growth and treatment by fractionated radiotherapy is presented. The model explicitly accounts for three time and space-dependent factors that influence the efficiency of radiotherapy fractionation schemes—tumor cell repopulation, reoxygenation and redistribution of proliferative states. A special algorithm is developed, aimed at finding the fractionation schemes that provide increased tumor cure probability under the constraints of maximum normal tissue damage and maximum fractional dose. The optimization procedure is performed for varied radiosensitivity of tumor cells under the values of model parameters, corresponding to different degrees of tumor malignancy. The resulting optimized schemes consist of two stages. The first stages are aimed to increase the radiosensitivity of the tumor cells, remaining after their end, sparing the caused normal tissue damage. This allows to increase the doses during the second stages and thus take advantage of the obtained increased radiosensitivity. Such method leads to significant expansions in the curative ranges of the values of tumor radiosensitivity parameters. Overall, the results of this study represent the theoretical proof of concept that non-uniform radiotherapy fractionation schemes may be considerably more effective that uniform ones, due to the time and space-dependent effects.
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Glazar DJ, Grass GD, Arrington JA, Forsyth PA, Raghunand N, Yu HHM, Sahebjam S, Enderling H. Tumor Volume Dynamics as an Early Biomarker for Patient-Specific Evolution of Resistance and Progression in Recurrent High-Grade Glioma. J Clin Med 2020; 9:E2019. [PMID: 32605050 PMCID: PMC7409184 DOI: 10.3390/jcm9072019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 11/16/2022] Open
Abstract
Recurrent high-grade glioma (HGG) remains incurable with inevitable evolution of resistance and high inter-patient heterogeneity in time to progression (TTP). Here, we evaluate if early tumor volume response dynamics can calibrate a mathematical model to predict patient-specific resistance to develop opportunities for treatment adaptation for patients with a high risk of progression. A total of 95 T1-weighted contrast-enhanced (T1post) MRIs from 14 patients treated in a phase I clinical trial with hypo-fractionated stereotactic radiation (HFSRT; 6 Gy × 5) plus pembrolizumab (100 or 200 mg, every 3 weeks) and bevacizumab (10 mg/kg, every 2 weeks; NCT02313272) were delineated to derive longitudinal tumor volumes. We developed, calibrated, and validated a mathematical model that simulates and forecasts tumor volume dynamics with rate of resistance evolution as the single patient-specific parameter. Model prediction performance is evaluated based on how early progression is predicted and the number of false-negative predictions. The model with one patient-specific parameter describing the rate of evolution of resistance to therapy fits untrained data ( R 2 = 0.70 ). In a leave-one-out study, for the nine patients that had T1post tumor volumes ≥1 cm3, the model was able to predict progression on average two imaging cycles early, with a median of 9.3 (range: 3-39.3) weeks early (median progression-free survival was 27.4 weeks). Our results demonstrate that early tumor volume dynamics measured on T1post MRI has the potential to predict progression following the protocol therapy in select patients with recurrent HGG. Future work will include testing on an independent patient dataset and evaluation of the developed framework on T2/FLAIR-derived data.
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Affiliation(s)
- Daniel J. Glazar
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
| | - G. Daniel Grass
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (G.D.G.); (H.-H.M.Y.)
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
| | - John A. Arrington
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
- Department of Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
- Department of Orthopaedics & Sports Medicine, University of South Florida, Tampa, FL 33612, USA
- Department of Radiology, University of South Florida, Tampa, FL 33612, USA
| | - Peter A. Forsyth
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
- Department of Neuro-Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Natarajan Raghunand
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Hsiang-Hsuan Michael Yu
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (G.D.G.); (H.-H.M.Y.)
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
| | - Solmaz Sahebjam
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
- Department of Neuro-Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Heiko Enderling
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (G.D.G.); (H.-H.M.Y.)
- Department of Oncologic Sciences, University of South Florida, Tampa, FL 33612, USA; (J.A.A.); (P.A.F.); (N.R.)
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Hormuth DA, Jarrett AM, Lima EABF, McKenna MT, Fuentes DT, Yankeelov TE. Mechanism-Based Modeling of Tumor Growth and Treatment Response Constrained by Multiparametric Imaging Data. JCO Clin Cancer Inform 2020; 3:1-10. [PMID: 30807209 DOI: 10.1200/cci.18.00055] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Multiparametric imaging is a critical tool in the noninvasive study and assessment of cancer. Imaging methods have evolved over the past several decades to provide quantitative measures of tumor and healthy tissue characteristics related to, for example, cell number, blood volume fraction, blood flow, hypoxia, and metabolism. Mechanistic models of tumor growth also have matured to a point where the incorporation of patient-specific measures could provide clinically relevant predictions of tumor growth and response. In this review, we identify and discuss approaches that use multiparametric imaging data, including diffusion-weighted magnetic resonance imaging, dynamic contrast-enhanced magnetic resonance imaging, diffusion tensor imaging, contrast-enhanced computed tomography, [18F]fluorodeoxyglucose positron emission tomography, and [18F]fluoromisonidazole positron emission tomography to initialize and calibrate mechanistic models of tumor growth and response. We focus the discussion on brain and breast cancers; however, we also identify three emerging areas of application in kidney, pancreatic, and lung cancers. We conclude with a discussion of the future directions for incorporating multiparametric imaging data and mechanistic modeling into clinical decision making for patients with cancer.
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Affiliation(s)
| | | | | | | | - David T Fuentes
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Hawkins-Daarud A, Johnston SK, Swanson KR. Quantifying Uncertainty and Robustness in a Biomathematical Model-Based Patient-Specific Response Metric for Glioblastoma. JCO Clin Cancer Inform 2020; 3:1-8. [PMID: 30758984 PMCID: PMC6633916 DOI: 10.1200/cci.18.00066] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Glioblastomas, lethal primary brain tumors, are known for their heterogeneity and invasiveness. A growing body of literature has been developed demonstrating the clinical relevance of a biomathematical model, the proliferation-invasion model, of glioblastoma growth. Of interest here is the development of a treatment response metric, days gained (DG). This metric is based on individual tumor kinetics estimated through segmented volumes of hyperintense regions on T1-weighted gadolinium-enhanced and T2-weighted magnetic resonance images. This metric was shown to be prognostic of time to progression. Furthermore, it was shown to be more prognostic of outcome than standard response metrics. Although promising, the original article did not account for uncertainty in the calculation of the DG metric, leaving the robustness of this cutoff in question. Methods We harnessed the Bayesian framework to consider the impact of two sources of uncertainty: (1) image acquisition and (2) interobserver error in image segmentation. We first used synthetic data to characterize what nonerror variants are influencing the final uncertainty in the DG metric. We then considered the original patient cohort to investigate clinical patterns of uncertainty and to determine how robust this metric is for predicting time to progression and overall survival. Results Our results indicate that the key clinical variants are the time between pretreatment images and the underlying tumor growth kinetics, matching our observations in the clinical cohort. Finally, we demonstrated that for this cohort, there was a continuous range of cutoffs between 94 and 105 for which the prediction of the time to progression was over 80% reliable. Conclusion Although additional validation must be performed, this work represents a key step in ascertaining the clinical utility of this metric.
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40
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Storey K, Leder K, Hawkins-Daarud A, Swanson K, Ahmed AU, Rockne RC, Foo J. Glioblastoma Recurrence and the Role of O 6-Methylguanine-DNA Methyltransferase Promoter Methylation. JCO Clin Cancer Inform 2020; 3:1-12. [PMID: 30758983 DOI: 10.1200/cci.18.00062] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Tumor recurrence in glioblastoma multiforme (GBM) is often attributed to acquired resistance to the standard chemotherapeutic agent, temozolomide (TMZ). Promoter methylation of the DNA repair gene MGMT (O6-methylguanine-DNA methyltransferase) has been associated with sensitivity to TMZ, whereas increased expression of MGMT has been associated with TMZ resistance. Clinical studies have observed a downward shift in MGMT methylation percentage from primary to recurrent stage tumors; however, the evolutionary processes that drive this shift and more generally the emergence and growth of TMZ-resistant tumor subpopulations are still poorly understood. Here, we develop a mathematical model, parameterized using clinical and experimental data, to investigate the role of MGMT methylation in TMZ resistance during the standard treatment regimen for GBM-surgery, chemotherapy, and radiation. We first found that the observed downward shift in MGMT promoter methylation status between detection and recurrence cannot be explained solely by evolutionary selection. Next, our model suggests that TMZ has an inhibitory effect on maintenance methylation of MGMT after cell division. Finally, incorporating this inhibitory effect, we study the optimal number of TMZ doses per adjuvant cycle for patients with GBM with high and low levels of MGMT methylation at diagnosis.
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Affiliation(s)
- Katie Storey
- University of Minnesota Twin Cities, Minneapolis, MN
| | - Kevin Leder
- University of Minnesota Twin Cities, Minneapolis, MN
| | | | | | - Atique U Ahmed
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Jasmine Foo
- University of Minnesota Twin Cities, Minneapolis, MN
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Mang A, Bakas S, Subramanian S, Davatzikos C, Biros G. Integrated Biophysical Modeling and Image Analysis: Application to Neuro-Oncology. Annu Rev Biomed Eng 2020; 22:309-341. [PMID: 32501772 PMCID: PMC7520881 DOI: 10.1146/annurev-bioeng-062117-121105] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Central nervous system (CNS) tumors come with vastly heterogeneous histologic, molecular, and radiographic landscapes, rendering their precise characterization challenging. The rapidly growing fields of biophysical modeling and radiomics have shown promise in better characterizing the molecular, spatial, and temporal heterogeneity of tumors. Integrative analysis of CNS tumors, including clinically acquired multi-parametric magnetic resonance imaging (mpMRI) and the inverse problem of calibrating biophysical models to mpMRI data, assists in identifying macroscopic quantifiable tumor patterns of invasion and proliferation, potentially leading to improved (a) detection/segmentation of tumor subregions and (b) computer-aided diagnostic/prognostic/predictive modeling. This article presents a summary of (a) biophysical growth modeling and simulation,(b) inverse problems for model calibration, (c) these models' integration with imaging workflows, and (d) their application to clinically relevant studies. We anticipate that such quantitative integrative analysis may even be beneficial in a future revision of the World Health Organization (WHO) classification for CNS tumors, ultimately improving patient survival prospects.
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Affiliation(s)
- Andreas Mang
- Department of Mathematics, University of Houston, Houston, Texas 77204, USA;
| | - Spyridon Bakas
- Department of Mathematics, University of Houston, Houston, Texas 77204, USA;
| | - Shashank Subramanian
- Oden Institute of Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, USA; ,
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA); Department of Radiology; and Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; ,
| | - George Biros
- Oden Institute of Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, USA; ,
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Simulating glioblastoma growth consisting both visible and invisible parts of the tumor using a diffusion-reaction model followed by resection and radiotherapy. Acta Neurol Belg 2020; 120:629-637. [PMID: 29869778 DOI: 10.1007/s13760-018-0952-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/23/2018] [Indexed: 02/04/2023]
Abstract
Glioblastoma is known to be among one of the deadliest brain tumors in the world today. There have been major improvements in the detection of cancerous cells in the twenty-first century. However, the threshold of detection of these cancerous cells varies in different scanning techniques such as magnetic resonance imaging (MRI) and computed tomography (CT). The growth of these tumors and different treatments have been modeled to assist medical experts in better predictions of the related tumor growth and in the selection of more accurate treatments. In clinical terms the tumor consisted of two parts known as the visible part, which is the part of the tumor that is above the threshold of the detecting device and the invisible part, which is below the detecting threshold. In this study, the common reaction-diffusion model of tumor growth is used to simulate the growth of the glioblastoma tumor. Also resection and radiotherapy have been modeled as methods to prevent the growth of the tumor. The results demonstrate that although the selected treatments were effective in reducing the number of cancerous cells to under the threshold of detection, they did not eliminate all cancerous cells and if no further treatments were applied, the cancerous cells would spread and become malignant again. Although previous studies have suggested that the ratio of proliferation to diffusion could describe the malignancy of the tumor, this study in addition shows the importance of each of the coefficients regarding the malignancy of the tumor.
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Whitmire P, Rickertsen CR, Hawkins-Daarud A, Carrasco E, Lorence J, De Leon G, Curtin L, Bayless S, Clark-Swanson K, Peeri NC, Corpuz C, Lewis-de Los Angeles CP, Bendok BR, Gonzalez-Cuyar L, Vora S, Mrugala MM, Hu LS, Wang L, Porter A, Kumthekar P, Johnston SK, Egan KM, Gatenby R, Canoll P, Rubin JB, Swanson KR. Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients. BMC Cancer 2020; 20:447. [PMID: 32429869 PMCID: PMC7238585 DOI: 10.1186/s12885-020-06816-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 04/01/2020] [Indexed: 11/19/2022] Open
Abstract
Background Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results Among males, tumor (T1Gd) radius was a predictor of overall survival (HR = 1.027, p = 0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR = 1.011, p < 0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p = 0.010 t-test), but tumor size was not correlated with female overall survival (p = 0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p = 0.004, F p = 0.001, t-test). Conclusion Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.
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Affiliation(s)
- Paula Whitmire
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA.
| | - Cassandra R Rickertsen
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Andrea Hawkins-Daarud
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Eduardo Carrasco
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Julia Lorence
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Gustavo De Leon
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Lee Curtin
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA.,Centre for Mathematical Medicine and Biology, University of Nottingham, Nottingham, UK
| | - Spencer Bayless
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Kamala Clark-Swanson
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
| | - Noah C Peeri
- Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Christina Corpuz
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | | | - Bernard R Bendok
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA.,Department of Neurologic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Luis Gonzalez-Cuyar
- Department of Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA
| | - Sujay Vora
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA
| | | | - Leland S Hu
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Lei Wang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alyx Porter
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
| | - Priya Kumthekar
- Department of Neurology, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sandra K Johnston
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA.,Department of Radiology, University of Washington, Seattle, WA, USA
| | - Kathleen M Egan
- Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Robert Gatenby
- Cancer Biology and Evolution Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Peter Canoll
- Division of Neuropathology, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Kristin R Swanson
- Precision Neurotherapeutics Innovation Program, Mayo Clinic, 5777 East Mayo Blvd , SSB 02-700, Phoenix, AZ, 85054, USA
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Aherne NJ, Dhawan A, Scott JG, Enderling H. Mathematical oncology and it's application in non melanoma skin cancer - A primer for radiation oncology professionals. Oral Oncol 2020; 103:104473. [PMID: 32109841 DOI: 10.1016/j.oraloncology.2019.104473] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022]
Abstract
Cancers of the skin (the majority of which are basal and squamous cell skin carcinomas, but also include the rarer Merkel cell carcinoma) are overwhelmingly the most common of all types of cancer. Most of these are treated surgically, with radiation reserved for those patients with high risk features or anatomical locations less suitable for surgery. Given the high incidence of both basal and squamous cell carcinomas, as well as the relatively poor outcome for Merkel cell carcinoma, it is useful to investigate the role of other disciplines regarding their diagnosis, staging and treatment. Mathematical modelling is one such area of investigation. The use of mathematical modelling is a relatively recent addition to the armamentarium of cancer treatment. It has long been recognised that tumour growth and treatment response is a complex, non-linear biological phenomenon with many mechanisms yet to be understood. Despite decades of research, including clinical, population and basic science approaches, we continue to be challenged by the complexity, heterogeneity and adaptability of tumours, both in individual patients in the oncology clinic and across wider patient populations. Prospective clinical trials predominantly focus on average outcome, with little understanding as to why individual patients may or may not respond. The use of mathematical models may lead to a greater understanding of tumour initiation, growth dynamics and treatment response.
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Affiliation(s)
- Noel J Aherne
- Department of Radiation Oncology, Mid North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia; RCS Faculty of Medicine, University of New South Wales, New South Wales, Australia.
| | - Andrew Dhawan
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA; Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jacob G Scott
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Heiko Enderling
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA; Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Yang W, Warrington NM, Taylor SJ, Whitmire P, Carrasco E, Singleton KW, Wu N, Lathia JD, Berens ME, Kim AH, Barnholtz-Sloan JS, Swanson KR, Luo J, Rubin JB. Sex differences in GBM revealed by analysis of patient imaging, transcriptome, and survival data. Sci Transl Med 2020; 11:11/473/eaao5253. [PMID: 30602536 DOI: 10.1126/scitranslmed.aao5253] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 08/20/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Sex differences in the incidence and outcome of human disease are broadly recognized but, in most cases, not sufficiently understood to enable sex-specific approaches to treatment. Glioblastoma (GBM), the most common malignant brain tumor, provides a case in point. Despite well-established differences in incidence and emerging indications of differences in outcome, there are few insights that distinguish male and female GBM at the molecular level or allow specific targeting of these biological differences. Here, using a quantitative imaging-based measure of response, we found that standard therapy is more effective in female compared with male patients with GBM. We then applied a computational algorithm to linked GBM transcriptome and outcome data and identified sex-specific molecular subtypes of GBM in which cell cycle and integrin signaling are the critical determinants of survival for male and female patients, respectively. The clinical relevance of cell cycle and integrin signaling pathway signatures was further established through correlations between gene expression and in vitro chemotherapy sensitivity in a panel of male and female patient-derived GBM cell lines. Together, these results suggest that greater precision in GBM molecular subtyping can be achieved through sex-specific analyses and that improved outcomes for all patients might be accomplished by tailoring treatment to sex differences in molecular mechanisms.
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Affiliation(s)
- Wei Yang
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Nicole M Warrington
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sara J Taylor
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Paula Whitmire
- Precision Neurotherapeutics Innovation Program, Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Eduardo Carrasco
- Precision Neurotherapeutics Innovation Program, Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Kyle W Singleton
- Precision Neurotherapeutics Innovation Program, Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Ningying Wu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.,School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Justin D Lathia
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland OH, 44195, USA
| | | | - Albert H Kim
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO 63110, USA.,Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Kristin R Swanson
- Precision Neurotherapeutics Innovation Program, Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, AZ 85054, USA.,School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Jingqin Luo
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA. .,Siteman Cancer Center Biostatistics Core, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA. .,Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA
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46
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Montaseri G, Alfonso JCL, Hatzikirou H, Meyer-Hermann M. A minimal modeling framework of radiation and immune system synergy to assist radiotherapy planning. J Theor Biol 2020; 486:110099. [PMID: 31790681 DOI: 10.1016/j.jtbi.2019.110099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/15/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023]
Abstract
Recent evidence indicates the ability of radiotherapy to induce local and systemic tumor-specific immune responses as a result of immunogenic cell death. However, fractionation regimes routinely used in clinical practice typically ignore the synergy between radiation and the immune system, and instead attempt to completely eradicate tumors by the direct lethal effect of radiation on cancer cells. This paradigm is expected to change in the near future due to the potential benefits of considering radiation-induced antitumor immunity during treatment planning. Towards this goal, we propose a minimal modeling framework based on key aspects of the tumor-immune system interplay to simulate the effects of radiation on tumors and the immunological consequences of radiotherapy. The impacts of tumor-associated vasculature and intratumoral oxygen-mediated heterogeneity on treatment outcomes are ininvestigated. The model provides estimates of the minimum radiation doses required for tumor eradication given a certain number of treatment fractions. Moreover, estimates of treatment duration for disease control given predetermined fractional radiation doses can be also obtained. Although theoretical in nature, this study motivates the development and establishment of immune-based decision-support tools in radiotherapy planning.
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Affiliation(s)
- Ghazal Montaseri
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Centre for Individualised Infection Medicine (CIIM), Hannover, Germany
| | - Juan Carlos López Alfonso
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
| | - Haralampos Hatzikirou
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Michael Meyer-Hermann
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Centre for Individualised Infection Medicine (CIIM), Hannover, Germany; Institute of Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Germany.
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47
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Meghdadi N, Soltani M, Niroomand-Oscuii H, Yamani N. Personalized image-based tumor growth prediction in a convection-diffusion-reaction model. Acta Neurol Belg 2020; 120:49-57. [PMID: 30019255 DOI: 10.1007/s13760-018-0973-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/02/2018] [Indexed: 11/26/2022]
Abstract
Inter-individual heterogeneity of tumors leads to non-effectiveness of unique therapy plans. This issue has caused a growing interest in the field of personalized medicine and its application in tumor growth evaluation. Accordingly, in this paper, a framework of personalized medicine is presented for growth prediction of brain glioma tumors. A convection-diffusion-reaction model is used as the patient-specific tumor growth model which is associated with multimodal magnetic resonance images (MRIs). Two parameters of intracellular area fraction (ICAF) and metabolic rate have been used to incorporate the physiological data obtained from medical images into the model. The framework is tested on the data of two cases of glioma tumors to document the approach; parameter estimation is made using particle swarm optimization (PSO) and genetic algorithm (GA) and the model is evaluated by comparing the predicted tumors with the observed tumors in terms of root mean square error of the ICAF maps (IRMSE), relative area difference (RAD) and Dice's coefficient (DC). Results show the differences of IRMSE, RAD and DC in 4.1 ∓ 1.15%, 0.099 ∓ 0.041 and 85.5 ∓ 7.5%, respectively. Survival times are estimated by assuming the tumor radius of 35 mm as the fatal burden. Results confirm that less-diffusive tumors lead to higher survival times. The represented framework makes it possible to personally predict the growth behavior of glioma tumors only based on patients' routine MRIs and provides a basis for modeling the personalized therapy and walking in the path of personalized medicine.
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Affiliation(s)
- Nargess Meghdadi
- Division of Biomechanics, Department of Mechanical Engineering, Sahand University of Technology, Tabriz, Iran
| | - M Soltani
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran.
- University of Waterloo, Waterloo, ON, Canada.
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Advanced Bioengineering Initiative Center, Computational Medicine Institute, Tehran, Iran.
| | - Hanieh Niroomand-Oscuii
- Division of Biomechanics, Department of Mechanical Engineering, Sahand University of Technology, Tabriz, Iran.
| | - Nooshin Yamani
- Department of Neurology, Danish Headache Center, University of Copenhagen, Copenhagen, Denmark
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48
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Sahoo P, Yang X, Abler D, Maestrini D, Adhikarla V, Frankhouser D, Cho H, Machuca V, Wang D, Barish M, Gutova M, Branciamore S, Brown CE, Rockne RC. Mathematical deconvolution of CAR T-cell proliferation and exhaustion from real-time killing assay data. J R Soc Interface 2020; 17:20190734. [PMID: 31937234 PMCID: PMC7014796 DOI: 10.1098/rsif.2019.0734] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Chimeric antigen receptor (CAR) T-cell therapy has shown promise in the treatment of haematological cancers and is currently being investigated for solid tumours, including high-grade glioma brain tumours. There is a desperate need to quantitatively study the factors that contribute to the efficacy of CAR T-cell therapy in solid tumours. In this work, we use a mathematical model of predator–prey dynamics to explore the kinetics of CAR T-cell killing in glioma: the Chimeric Antigen Receptor T-cell treatment Response in GliOma (CARRGO) model. The model includes rates of cancer cell proliferation, CAR T-cell killing, proliferation, exhaustion, and persistence. We use patient-derived and engineered cancer cell lines with an in vitro real-time cell analyser to parametrize the CARRGO model. We observe that CAR T-cell dose correlates inversely with the killing rate and correlates directly with the net rate of proliferation and exhaustion. This suggests that at a lower dose of CAR T-cells, individual T-cells kill more cancer cells but become more exhausted when compared with higher doses. Furthermore, the exhaustion rate was observed to increase significantly with tumour growth rate and was dependent on level of antigen expression. The CARRGO model highlights nonlinear dynamics involved in CAR T-cell therapy and provides novel insights into the kinetics of CAR T-cell killing. The model suggests that CAR T-cell treatment may be tailored to individual tumour characteristics including tumour growth rate and antigen level to maximize therapeutic benefit.
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Affiliation(s)
- Prativa Sahoo
- Department of Computational and Quantitative Medicine, Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Xin Yang
- Department of Hematology and Hematopoietic Cell Translation and Immuno-Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Daniel Abler
- Department of Computational and Quantitative Medicine, Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Davide Maestrini
- Department of Computational and Quantitative Medicine, Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Vikram Adhikarla
- Department of Computational and Quantitative Medicine, Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - David Frankhouser
- Department of Diabetes Complications and Metabolism, City of Hope National Medical Center, Duarte, CA, USA
| | - Heyrim Cho
- Department of Mathematics, University of California, Riverside, CA, USA
| | - Vanessa Machuca
- Mathematical and Computational Systems Biology, University of California, Irvine, CA, USA
| | - Dongrui Wang
- Department of Hematology and Hematopoietic Cell Translation and Immuno-Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Michael Barish
- Department of Developmental and Stem Cell Biology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Margarita Gutova
- Department of Developmental and Stem Cell Biology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Sergio Branciamore
- Department of Diabetes Complications and Metabolism, City of Hope National Medical Center, Duarte, CA, USA
| | - Christine E Brown
- Department of Hematology and Hematopoietic Cell Translation and Immuno-Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Department of Computational and Quantitative Medicine, Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
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49
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Lewin TD, Byrne HM, Maini PK, Caudell JJ, Moros EG, Enderling H. The importance of dead material within a tumour on the dynamics in response to radiotherapy. ACTA ACUST UNITED AC 2020; 65:015007. [DOI: 10.1088/1361-6560/ab4c27] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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50
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Singleton KW, Porter AB, Hu LS, Johnston SK, Bond KM, Rickertsen CR, De Leon G, Whitmire SA, Clark-Swanson KR, Mrugala MM, Swanson KR. Days gained response discriminates treatment response in patients with recurrent glioblastoma receiving bevacizumab-based therapies. Neurooncol Adv 2020; 2:vdaa085. [PMID: 32864609 PMCID: PMC7447137 DOI: 10.1093/noajnl/vdaa085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Accurate assessments of patient response to therapy are a critical component of personalized medicine. In glioblastoma (GBM), the most aggressive form of brain cancer, tumor growth dynamics are heterogenous across patients, complicating assessment of treatment response. This study aimed to analyze days gained (DG), a burgeoning model-based dynamic metric, for response assessment in patients with recurrent GBM who received bevacizumab-based therapies.
Methods
DG response scores were calculated using volumetric tumor segmentations for patients receiving bevacizumab with and without concurrent cytotoxic therapy (N = 62). Kaplan–Meier and Cox proportional hazards analyses were implemented to examine DG prognostic relationship to overall (OS) and progression-free survival (PFS) from the onset of treatment for recurrent GBM.
Results
In patients receiving concurrent bevacizumab and cytotoxic therapy, Kaplan–Meier analysis showed significant differences in OS and PFS at DG cutoffs consistent with previously identified values from newly diagnosed GBM using T1-weighted gadolinium-enhanced magnetic resonance imaging (T1Gd). DG scores for bevacizumab monotherapy patients only approached significance for PFS. Cox regression showed that increases of 25 DG on T1Gd imaging were significantly associated with a 12.5% reduction in OS hazard for concurrent therapy patients and a 4.4% reduction in PFS hazard for bevacizumab monotherapy patients.
Conclusion
DG has significant meaning in recurrent therapy as a metric of treatment response, even in the context of anti-angiogenic therapies. This provides further evidence supporting the use of DG as an adjunct response metric that quantitatively connects treatment response and clinical outcomes.
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Affiliation(s)
- Kyle W Singleton
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
| | - Alyx B Porter
- Division of Neuro-Oncology, Department of Neurology, Mayo Clinic, Phoenix, AZ
| | - Leland S Hu
- Department of Radiology, Mayo Clinic, Phoenix, Arizona
| | - Sandra K Johnston
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
- Department of Radiology, University of Washington, Seattle, Washington
| | - Kamila M Bond
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Cassandra R Rickertsen
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
| | - Gustavo De Leon
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
| | - Scott A Whitmire
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
| | - Kamala R Clark-Swanson
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
| | - Maciej M Mrugala
- Division of Neuro-Oncology, Department of Neurology, Mayo Clinic, Phoenix, AZ
| | - Kristin R Swanson
- Mathematical NeuroOncology Lab, Precision NeuroTherapeutics Innovation Program, Mayo Clinic, Phoenix, Arizona
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona
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