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Belfatto A, Jereczek-Fossa BA, Baroni G, Cerveri P. Model-Supported Radiotherapy Personalization: In silico Test of Hyper- and Hypo-Fractionation Effects. Front Physiol 2018; 9:1445. [PMID: 30374310 PMCID: PMC6197078 DOI: 10.3389/fphys.2018.01445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 09/24/2018] [Indexed: 12/25/2022] Open
Abstract
The need for radiotherapy personalization is now widely recognized, however, it would require considerations not only on the probability of control and survival of the tumor, but also on the possible toxic effects, on the quality of the expected life and the economic efficiency of the treatment. In this paper, we propose a simulation tool that can be integrated into a decision support system that allows selection of the most suitable irradiation regimen. We used a macroscale mathematical model, which includes active and necrotic tumor dynamics and the role of oxygenation to simulate the effects of different hypo-/hyper-fractional regimens using retrospective data of seven virtual patients from as many cervical cancer patients used for its training in a previous study. The results confirmed the heterogeneous response across the patients as a function of treatment regimen and suggested the tumor growth rate as a main factor in the final tumor regression. In addition to the maximum regression, another criterion was suggested to select the most suitable regimen (minimum number of fractions to achieve a regression of 80%) minimizing the toxicity and maximizing the cost-effectiveness ratio. Despite the lack of direct validation, the simulation results are in agreement with the literature findings that suggest the need for hypo-fractionated regimens in case of aggressive tumor phenotypes. Finally, the paper suggests a possible exploitation of the model within a tool to support clinical decisions.
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Affiliation(s)
- Antonella Belfatto
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Division of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Guido Baroni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Pietro Cerveri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy,*Correspondence: Pietro Cerveri,
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Li XL, Oduola WO, Qian L, Dougherty ER. Integrating Multiscale Modeling with Drug Effects for Cancer Treatment. Cancer Inform 2016; 14:21-31. [PMID: 26792977 PMCID: PMC4712979 DOI: 10.4137/cin.s30797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/08/2015] [Accepted: 11/15/2015] [Indexed: 12/12/2022] Open
Abstract
In this paper, we review multiscale modeling for cancer treatment with the incorporation of drug effects from an applied system's pharmacology perspective. Both the classical pharmacology and systems biology are inherently quantitative; however, systems biology focuses more on networks and multi factorial controls over biological processes rather than on drugs and targets in isolation, whereas systems pharmacology has a strong focus on studying drugs with regard to the pharmacokinetic (PK) and pharmacodynamic (PD) relations accompanying drug interactions with multiscale physiology as well as the prediction of dosage-exposure responses and economic potentials of drugs. Thus, it requires multiscale methods to address the need for integrating models from the molecular levels to the cellular, tissue, and organism levels. It is a common belief that tumorigenesis and tumor growth can be best understood and tackled by employing and integrating a multifaceted approach that includes in vivo and in vitro experiments, in silico models, multiscale tumor modeling, continuous/discrete modeling, agent-based modeling, and multiscale modeling with PK/PD drug effect inputs. We provide an example application of multiscale modeling employing stochastic hybrid system for a colon cancer cell line HCT-116 with the application of Lapatinib drug. It is observed that the simulation results are similar to those observed from the setup of the wet-lab experiments at the Translational Genomics Research Institute.
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Affiliation(s)
- Xiangfang L. Li
- Department of Electrical and Computer Engineering, Prairie View A&M University, Prairie View, TX, USA
| | - Wasiu O. Oduola
- Department of Electrical and Computer Engineering, Prairie View A&M University, Prairie View, TX, USA
| | - Lijun Qian
- Department of Electrical and Computer Engineering, Prairie View A&M University, Prairie View, TX, USA
| | - Edward R. Dougherty
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
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Marias K, Dionysiou D, Sakkalis V, Graf N, Bohle RM, Coveney PV, Wan S, Folarin A, Büchler P, Reyes M, Clapworthy G, Liu E, Sabczynski J, Bily T, Roniotis A, Tsiknakis M, Kolokotroni E, Giatili S, Veith C, Messe E, Stenzhorn H, Kim YJ, Zasada S, Haidar AN, May C, Bauer S, Wang T, Zhao Y, Karasek M, Grewer R, Franz A, Stamatakos G. Clinically driven design of multi-scale cancer models: the ContraCancrum project paradigm. Interface Focus 2011; 1:450-61. [PMID: 22670213 PMCID: PMC3262443 DOI: 10.1098/rsfs.2010.0037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 03/07/2011] [Indexed: 12/13/2022] Open
Abstract
The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the central motivation behind the ContraCancrum project. By developing integrated multi-scale cancer models, ContraCancrum is expected to contribute to the advancement of in silico oncology through the optimization of cancer treatment in the patient-individualized context by simulating the response to various therapeutic regimens. The aim of the present paper is to describe a novel paradigm for designing clinically driven multi-scale cancer modelling by bringing together basic science and information technology modules. In addition, the integration of the multi-scale tumour modelling components has led to novel concepts of personalized clinical decision support in the context of predictive oncology, as is also discussed in the paper. Since clinical adaptation is an inelastic prerequisite, a long-term clinical adaptation procedure of the models has been initiated for two tumour types, namely non-small cell lung cancer and glioblastoma multiforme; its current status is briefly summarized.
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Affiliation(s)
- K. Marias
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - D. Dionysiou
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - V. Sakkalis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - N. Graf
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - R. M. Bohle
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - P. V. Coveney
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - S. Wan
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. Folarin
- Cancer Research Institute, University College London, 72 Huntley Street, London WC1E 6BT, UK
| | - P. Büchler
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - M. Reyes
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - G. Clapworthy
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - E. Liu
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - J. Sabczynski
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - T. Bily
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - A. Roniotis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - M. Tsiknakis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - E. Kolokotroni
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - S. Giatili
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - C. Veith
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - E. Messe
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - H. Stenzhorn
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - Yoo-Jin Kim
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - S. Zasada
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. N. Haidar
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - C. May
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - S. Bauer
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - T. Wang
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - Y. Zhao
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - M. Karasek
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - R. Grewer
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - A. Franz
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - G. Stamatakos
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
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