Breast cancer is the leading cause of death in women with cancer worldwide. Investing in research has provided valuable knowledge that positively affects treatment. We already know very much about the mechanisms behind breast cancer, and can divide the disease into subgroups based on the molecular characteristics of the tumors. This helps to provide better treatment for patients and gives more survivors.
Now, scientists want to make cancer treatment even more effective by using mathematical models.
– In this project, together with our partners from the Department of Biostatistics, Alvaro Köhn-Luque and Arnoldo Frigessi, we will use mathematical models to determine, in advance, which combinations of treatment are most likely to work for patients, explains the coordinator of the EU project, researcher Vessela Kristensen.
By using data to test different combinations of cancer treatment, the goal is to be able to predict the right treatment to the right patient in a more effective way.
Unlimited combinations of treatment
Even within each subgroup of breast cancer, the disease appears to be very different and tumors develop differently from patient to patient. So despite solid experience from clinical trials, many patients do not receive adequate treatment.
Maybe the patient should be given other medications, a combination of several medications at a different dose or at a different interval. Then we potentially get an infinite number of combinations of treatment.
– We have many combinations for cancer drugs and not all of them can be tested in clinical trials. Both because it is incredibly expensive and because it takes a long time to do such studies, says Kristensen.
Computer based clinical trials
The idea of the RESCUER project is to make clinical trials faster and more efficient by doing them on the computer. They will create a model of the tumor, a so-called "in silico" tumor, where they can simulate real biological processes in an artificial environment.
– Patients must be treated according to medical guidelines. A doctor can medicate a patient once, while with the modeling, one can try and fail as many times as one wants. That's why we create parallel clinical trials in computer modeling for all of our patients, she explains.
– Then we look at every single dose of these drugs and how often they should be given. How many cancer cells do we measure after, for example, one week, six weeks, nine weeks?
Equations based on patient data
To make models of the tumor, they use different parameters or conditions from patient data. The information says something about what type of tumor the patient has, how big it is, how many cells it has and what kind of mutations this particular tumor has.
The information comes from the diagnostic process and treatment of the patients, such as mammography examinations, ultrasound, MRI images, molecular parameters and cell changes measured at different times.
– We measure all the parameters and put them into models. The parameters are real, they are measured in real people. Then we make differential equations on how the tumor will grow or shrink based on different conditions, she says.
The goal is to be able to analyze the correct parameters by doing that many times. Also to find out what needs to be measured in a tumor in order to predict what will be the right treatment for each patient.
– Every time we do that prediction, hopefully we have it so that we reach the goal faster and faster, says Kristensen.
The convergence environment PERCATHE
The EU project is an international collaboration project that has evolved from the convergence environment PERCATHE at UiO Life Sciences.
– The project started through a collaboration we have with the Department of Biostatistics with Köhn-Luque and Frigessi. RESCUER is a feather in the cap of this convergence environment that has evolved into an international EU project, says Kristensen.
The project will include oncologists, pathologists, radiologists, mathematicians, statisticians and molecular biologists. That is, both clinical and mathematical expertise with the participation of experts in many countries. Kristensen and colleagues will look at the biology of breast cancer. Frigessi and Köhn-Luque are in charge of the mathematical models and, together with Cambridge partners, will test which combinations are best.
To the top of the world's largest research program
The EU's Horizon2020 program is the world's largest research program. It is high prestige and very difficult to reach the top of the competition for funds. Both the Institute of Clinical Medicine and the Faculty of Medicine are very proud that the RESCUER project led by Vessela Kristensen has reached the top of the competition.
– My congratulations goes to Vessela Kristensen and collaborators who have succeeded to obtain funding from Horizon2020 and the recognition that comes with it. Kristensen's research has shown high quality over many years. She has succeeded in putting together a very good and innovative team to answer exciting research questions. In particular, I would like to emphasize the good cooperation between OUS and UiO as an important success factor for the project, says research dean Jens Petter Berg.
Large international network
Partners in the project are OUS, NTNU, University of Helsinki, University of Cambridge, Leuven University, Belgium, Rutgers, the state University of New Jersey, University of Barcelona, Karolinska Institute ,The Interdisciplinary Center Herzliya.
In addition, they collaborate with Hospital Clinic De Barcelona, University Hospital Erlangen, Institut Fur Frauengesundheit Gmbh, French Alternative Energies and Atomic Energy Commission, Nantomics Llc, IDIBAPS and Vib Vzw.