Towards the Personalized Treatment of Glioblastoma: Integrating Patient-Specific Clinical Data in a Continuous Mechanical Model

PLoS One. 2015 Jul 17;10(7):e0132887. doi: 10.1371/journal.pone.0132887. eCollection 2015.

Abstract

Glioblastoma multiforme (GBM) is the most aggressive and malignant among brain tumors. In addition to uncontrolled proliferation and genetic instability, GBM is characterized by a diffuse infiltration, developing long protrusions that penetrate deeply along the fibers of the white matter. These features, combined with the underestimation of the invading GBM area by available imaging techniques, make a definitive treatment of GBM particularly difficult. A multidisciplinary approach combining mathematical, clinical and radiological data has the potential to foster our understanding of GBM evolution in every single patient throughout his/her oncological history, in order to target therapeutic weapons in a patient-specific manner. In this work, we propose a continuous mechanical model and we perform numerical simulations of GBM invasion combining the main mechano-biological characteristics of GBM with the micro-structural information extracted from radiological images, i.e. by elaborating patient-specific Diffusion Tensor Imaging (DTI) data. The numerical simulations highlight the influence of the different biological parameters on tumor progression and they demonstrate the fundamental importance of including anisotropic and heterogeneous patient-specific DTI data in order to obtain a more accurate prediction of GBM evolution. The results of the proposed mathematical model have the potential to provide a relevant benefit for clinicians involved in the treatment of this particularly aggressive disease and, more importantly, they might drive progress towards improving tumor control and patient's prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anisotropy
  • Glioblastoma / drug therapy*
  • Glioblastoma / pathology
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Numerical Analysis, Computer-Assisted
  • Patient-Specific Modeling*
  • Precision Medicine*
  • Tumor Burden

Grants and funding

This work was partially supported by the “Start-up Packages and PhD Program” project, co-funded by Regione Lombardia through the “Fondo per lo sviluppo e la coesione 2007–2013 -formerly FAS”, and by the “Progetto Giovani GNFM 2014,” funded by the National Group of Mathematical Physics (GNFM-INdAM).