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- All Subjects: Cancer
- Creators: Kostelich, Eric
Over time, tumor treatment resistance inadvertently develops when androgen de-privation therapy (ADT) is applied to metastasized prostate cancer (PCa). To combat tumor resistance, while reducing the harsh side effects of hormone therapy, the clinician may opt to cyclically alternates the patient’s treatment on and off. This method,known as intermittent ADT, is an alternative to continuous ADT that improves the patient’s quality of life while testosterone levels recover between cycles. In this paper,we explore the response of intermittent ADT to metastasized prostate cancer by employing a previously clinical data validated mathematical model to new clinical data from patients undergoing Abiraterone therapy. This cell quota model, a system of ordinary differential equations constructed using Droop’s nutrient limiting theory, assumes the tumor comprises of castration-sensitive (CS) and castration-resistant (CR)cancer sub-populations. The two sub-populations rely on varying levels of intracellular androgen for growth, death and transformation. Due to the complexity of the model,we carry out sensitivity analyses to study the effect of certain parameters on their outputs, and to increase the identifiability of each patient’s unique parameter set. The model’s forecasting results show consistent accuracy for patients with sufficient data,which means the model could give useful information in practice, especially to decide whether an additional round of treatment would be effective.
Adaptive therapy utilizes competitive interactions between resistant and sensitive cells by keeping some sensitive cells to control tumor burden with the aim of increasing overall survival and time to progression. The use of adaptive therapy to treat breast cancer, ovarian cancer, and pancreatic cancer in preclinical models has shown significant results in controlling tumor growth. The purpose of this thesis is to draft a protocol to study adaptive therapy in a preclinical model of breast cancer on MCF7, estrogen receptor-positive, cells that have evolved resistance to fulvestrant and palbociclib (MCF7 R). In this study, we used two protocols: drug dose adjustment and intermittent therapy. The MCF7 R cell lines were injected into the mammary fat pads of 11-month-old NOD/SCID gamma (NSG) mice (18 mice) which were then treated with gemcitabine.<br/>The results of this experiment did not provide complete information because of the short-term treatments. In addition, we saw an increase in the tumor size of a few of the treated mice, which could be due to the metabolism of the drug at that age, or because of the difference in injection times. Therefore, these adaptive therapy protocols on hormone-refractory breast cancer cell lines will be repeated on young, 6-week old mice by injecting the cell lines at the same time for all mice, which helps the results to be more consistent and accurate.
prostate cancer is most commonly treated with hormonal therapy. The idea behind
hormonal therapy is to reduce androgen production, which prostate cancer cells
require for growth. Recently, the exploration of the synergistic effects of the drugs
used in hormonal therapy has begun. The aim was to build off of these recent
advancements and further refine the synergistic drug model. The advancements I
implement come by addressing biological shortcomings and improving the model’s
internal mechanistic structure. The drug families being modeled, anti-androgens,
and gonadotropin-releasing hormone analogs, interact with androgen production in a
way that is not completely understood in the scientific community. Thus the models
representing the drugs show progress through their ability to capture their effect
on serum androgen. Prostate-specific antigen is the primary biomarker for prostate
cancer and is generally how population models on the subject are validated. Fitting
the model to clinical data and comparing it to other clinical models through the
ability to fit and forecast prostate-specific antigen and serum androgen is how this
improved model achieves validation. The improved model results further suggest that
the drugs’ dynamics should be considered in adaptive therapy for prostate cancer.
Chapter 2 focuses sorely on time where the escape of a generic cancer out of immune control is described by stochastic delayed differential equations (SDDEs). Without time delay and noise, this system demonstrates bistability. The effects of response time of the immune system and stochasticity in the tumor proliferation rate are studied by including delay and noise in the model. Stability, persistence and extinction of the tumor are analyzed. The result shows that both time delay and noise can induce the transition from low tumor burden equilibrium to high tumor equilibrium. The aforementioned work has been published (Han et al., 2019b).
In Chapter 3, Glioblastoma multiforme (GBM) is studied using a partial differential equation (PDE) model. GBM is an aggressive brain cancer with a grim prognosis. A mathematical model of GBM growth with explicit motility, birth, and death processes is proposed. A novel method is developed to approximate key characteristics of the wave profile, which can be compared with MRI data. Several test cases of MRI data of GBM patients are used to yield personalized parameterizations of the model. The aforementioned work has been published (Han et al., 2019a).
Chapter 4 presents an innovative way of forecasting spatial cancer invasion. Most mathematical models, including the ones described in previous chapters, are formulated based on strong assumptions, which are hard, if not impossible, to verify due to complexity of biological processes and lack of quality data. Instead, a nonparametric forecasting method using Gaussian processes is proposed. By exploiting the local nature of the spatio-temporal process, sparse (in terms of time) data is sufficient for forecasting. Desirable properties of Gaussian processes facilitate selection of the size of the local neighborhood and computationally efficient propagation of uncertainty. The method is tested on synthetic data and demonstrates promising results.