Dynamic strategy for personalized medicine: An application to metastatic breast cancer

J Biomed Inform. 2017 Apr;68:50-57. doi: 10.1016/j.jbi.2017.02.012. Epub 2017 Feb 21.

Abstract

We compare methods to develop an adaptive strategy for therapy choice in a class of breast cancer patients, as an example of approaches to personalize therapies for individual characteristics and each patient's response to therapy. Our model maintains a Markov belief about the effectiveness of the different therapies and updates it as therapies are administered and tumor images are observed, reflecting tumor response. We compare three different approximate methods to solve our analytical model against standard medical practice and show significant potential benefit of the computed dynamic strategies to limit tumor growth and to reduce the number of time periods patients are given chemotherapy, with its attendant side effects.

Keywords: Breast cancer; Dynamic treatment strategy; Markov Decision Process; Personalized medicine.

MeSH terms

  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Humans
  • Markov Chains
  • Precision Medicine*