The Temozolomide-Doxorubicin paradox in Glioblastoma in vitro-in silico preclinical drug-screening.

Adjuvant Temozolomide is considered the front-line Glioblastoma chemotherapeutic treatment; yet not all patients respond. Latest trends in clinical trials usually refer to Doxorubicin; yet it can lead to severe side-effects if administered in high doses. While Glioblastoma prognosis remains poor, little is known about the combination of the two chemotherapeutics. Patient-derived spheroids were generated and treated with a range of Temozolomide/Doxorubicin concentrations either as monotherapy or in combination. Optical microscopy was used to monitor the growth pattern and cell death. Based on the monotherapy experiments, we developed a probabilistic mathematical framework in order to describe the drug-induced effect at the single-cell level and simulate drug doses in combination assuming probabilistic independence. Doxorubicin was found to be effective in doses even four orders of magnitude less than Temozolomide in monotherapy. The combination therapy doses tested in vitro were able to lead to irreversible growth inhibition at doses where monotherapy resulted in relapse. In our simulations, we assumed both drugs are anti-mitotic; Temozolomide has a growth-arrest effect, while Doxorubicin is able to cumulatively cause necrosis. Interestingly, under no mechanistic synergy assumption, the in silico predictions underestimate the in vitro results. In silico models allow the exploration of a variety of potential underlying hypotheses. The simulated-biological discrepancy at certain doses indicates a supra-additive response when both drugs are combined. Our results suggest a Temozolomide-Doxorubicin dual chemotherapeutic scheme to both disable proliferation and increase cytotoxicity against Glioblastoma.

Mathematical Modeling Evaluates How Vaccinations Affected the Course of COVID-19 Disease Progression.

The regulation policies implemented, the characteristics of vaccines, and the evolution of the virus continue to play a significant role in the progression of the SARS-CoV-2 pandemic. Numerous research articles have proposed using mathematical models to predict the outcomes of different scenarios, with the aim of improving awareness and informing policy-making. In this work, we propose an expansion to the classical SEIR epidemiological model that is designed to fit the complex epidemiological data of COVID-19. The model includes compartments for vaccinated, asymptomatic, hospitalized, and deceased individuals, splitting the population into two branches based on the severity of progression. In order to investigate the impact of the vaccination program on the spread of COVID-19 in Greece, this study takes into account the realistic vaccination program implemented in Greece, which includes various vaccination rates, different dosages, and the administration of booster shots. It also examines for the first time policy scenarios at crucial time-intervention points for Greece. In particular, we explore how alterations in the vaccination rate, immunity loss, and relaxation of measures regarding the vaccinated individuals affect the dynamics of COVID-19 spread. The modeling parameters revealed an alarming increase in the death rate during the dominance of the delta variant and before the initiation of the booster shot program in Greece. The existing probability of vaccinated people becoming infected and transmitting the virus sets them as catalytic players in COVID-19 progression. Overall, the modeling observations showcase how the criticism of different intervention measures, the vaccination program, and the virus evolution has been present throughout the various stages of the pandemic. As long as immunity declines, new variants emerge, and vaccine protection in reducing transmission remains incompetent; monitoring the complex vaccine and virus evolution is critical to respond proactively in the future.

Application of a Deep-Learning Technique to Non-Linear Images From Human Tissue Biopsies for Shedding New Light on Breast Cancer Diagnosis.

The development of label-free non-destructive techniques to be used as diagnostic tools in cancer research is of great importance for improving the quality of life for millions of patients. Previous studies have demonstrated that Third Harmonic Generation (THG) imaging could differentiate malignant from benign unlabeled human breast biopsies and distinguish the different grades of cancer. Towards the application of such technologies to clinic, in the present report, a deep learning technique was applied to THG images recorded from breast cancer tissues of grades 0, I, II, and III. By the implementation of a convolutional neural network (CNN) model, the differentiation of malignant from benign breast tissue samples and the discrimination of the different grades of cancer in a fast and accurate way were achieved. The obtained results provide a step ahead towards the use of optical diagnostic tools in conjunction with the CNN image classifier for the reliable and rapid malignancy diagnosis in clinic.

Modeling How Heterogeneity in Cell Cycle Length Affects Cancer Cell Growth Dynamics in Response to Treatment.

Tumors are complex, dynamic, and adaptive biological systems characterized by high heterogeneity at genetic, epigenetic, phenotypic, as well as tissue microenvironmental level. In this work, utilizing cellular automata methods, we focus on intrinsic heterogeneity with respect to cell cycle duration and explore whether and to what extent this heterogeneity affects cancer cell growth dynamics when cytotoxic treatment is applied. We assume that treatment acts on cancer cells specifically during mitosis and compare it with a (cell cycle-non-specific) cytotoxic treatment that acts randomly regardless of the cell cycle phase. We simulate the spatiotemporal evolution of tumor cells with different initial spatial configurations and different cell length probability distributions. We observed that in heterogeneous populations, strong selection forces act on cancer cells favoring the faster cells, when the death rates are lower than the proliferation rates. However, at higher mitotic death rates, selection of the slower proliferative cells is favored, leading to slower post-treatment regrowth rates, as compared to untreated growth. Of note, random cell death progressively eliminates the slower proliferative cells, consistently, favoring highly proliferative phenotypes. Interestingly, compared to the monoclonal populations that exhibit complete response at high random death rates, emergent resistance arises naturally in heterogeneous populations during treatment. As divergent selection forces may act on a heterogeneous cancer cell population, we argue that treatment plan selection can considerably alter the post-treatment tumor dynamics, cell survival, and emergence of resistance, proving its significant biological and therapeutic impact.

A Framework Linking Glycolytic Metabolic Capabilities and Tumor Dynamics.

Metabolic reprogramming is a hallmark of cancer. The main aim of this paper is to integrate a genome-scale metabolic description of tumor cells into a tumor growth model that accounts for the spatiotemporally heterogeneous tumor microenvironment, in order to study the effects of microscopic characteristics on tumor evolution. A lactate maximization metabolic strategy that allows near-optimal growth solution, while maximizing lactate secretion, is assumed. The proposed sub-cellular metabolic model is then incorporated into a hybrid discrete-continuous model of tumor growth. We produced several phenotypes by applying different constraints and optimization criteria in the metabolic model and explored the tumor evolution of the various phenotypes in different vasculature conditions and extracellular matrix densities. At first, we showed that the metabolic capabilities of phenotypes depending on resource availability can vary in a counter-intuitive manner. We then showed that: first, tumor population, morphology, and spread are affected differently in different conditions, allowing thus phenotypes to be superior than others in different conditions; and second, polyclonal tumors consisting of different phenotypes can exploit their different metabolic capabilities to enhance further tumor evolution. The proposed framework comprises a proof-of-concept demonstration showing the importance of considering the metabolic capabilities of phenotypes on predicting tumor evolution. The proposed framework allows the incorporation of context-specific and patient-specific data for the study of personalized tumor evolution and therapy efficacy, linking genome to metabolic capabilities and tumor dynamics.

The Importance of Neighborhood Scheme Selection in Agent-based Tumor Growth Modeling.

Modeling tumor growth has proven a very challenging problem, mainly due to the fact that tumors are highly complex systems that involve dynamic interactions spanning multiple scales both in time and space. The desire to describe interactions in various scales has given rise to modeling approaches that use both continuous and discrete variables, known as hybrid approaches. This work refers to a hybrid model on a 2D square lattice focusing on cell movement dynamics as they play an important role in tumor morphology, invasion and metastasis and are considered as indicators for the stage of malignancy used for early prognosis and effective treatment. Considering various distributions of the microenvironment, we explore how Neumann vs. Moore neighborhood schemes affects tumor growth and morphology. The results indicate that the importance of neighborhood selection is critical under specific conditions that include i) increased hapto/chemo-tactic coefficient, ii) a rugged microenvironment and iii) ECM degradation.

Employing in-vivo molecular imaging in simulating and validating tumor growth.

During the last decades, especially via the EU initiative related to the Virtual Physiological Human, significant progress has been made in advancing "in-silico" computational models to produce accurate and reliable tumor growth simulations. However, currently most attempts to validate the outcome of the models are either done in-vitro or ex-vivo after tumor resection. In this work, we incorporate information provided by fluorescence molecular tomography performed in-vivo into a mathematical model that describes tumor growth. The outcome is validated against tumor evolution snapshots captured in-vivo using advanced molecular probes in laboratory animals. The simulations are inline with the actual in-vivo growth and although alternative modeling parameters can lead to similar results challenging for additional microscopic information and imaging modalities to drive the in-silico models, they all show that hypoxia plays a dominant role in the evolution of the tumor under study.