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Mathematics will help choose the optimal treatment for bladder cancer

MIPT scientists together with their colleagues from St. Petersburg and Israel have analyzed more than 500 previously published scientific articles and proposed their own approach to the choice of methods used for the treatment of one of the most common cancers. Details are published in the review of the International Journal of Cancer.

Researchers from MIPT (Moscow Institute of Physics and Technology), St. Petersburg State Pediatric Medical University and Israel’s Ariel University, while making their choice, proposed to use clinical data on the concentration of certain proteins (biomarkers). With this information, mathematical models developed by this team allow making a choice between the conservative treatment (without surgery) and radical (surgical) intervention. Moreover, the authors believe that this approach will allow to select the optimal treatment for each patient.

Bladder cancer is one of the most common cancers; statistics show that 1 in 26 men and 1 in 90 women are susceptible to this form of cancer. In Russia, the number of cases is estimated at 12,500 per year, and therefore the problem of accurate diagnosis of the cancer stage and proper treatment is important both from a scientific and clinical point of view.

With proper diagnosis and timely detection, non-invasive bladder cancer is successfully treated. The tumor practically always begins to grow in the layer of cells that lines the bladder from inside – the epithelium – and if this tumor does not have time to affect the muscle layer, then it is possible to remove it with minimal risk of recurrence. However, if the tumor has penetrated into the muscle of the bladder, then the cancer is called muscle-invasive; the latter is much more active in producing metastasis, and chances of full recovery are sharply decreased. Nowadays, the five-year survival rate for muscle-invasive bladder cancer is 30 to 50% – these figures indicate the number of patients surviving for five years after the discovery of such a tumor.

“In this work we correlate the latest clinical, molecular and cellular data associated with muscle-invasive bladder cancer. We use this data for developing a mathematical model of the disease. The ultimate goals of our work are, firstly, the identification of biomarkers and specific clinical parameters by means of which it is possible to accurately determine the stage of this aggressive form of cancer; secondly – the development of individual strategies for its treatment in each particular case,” Alexander Kiselev, a professor of MIPT and lead author of the new article.

Bladder cancer occurs for various reasons – in fact, we are talking about heterogeneous (non-uniform) tumors with different biochemical and cellular characteristics, different genetic and epigenetic profiles, and all this possibly found in the same patient. Depending on which particular mutations occurred in the DNA of a cancer cell, the tumor grown therefrom may respond differently to therapy. Determining the exact type of tumor (profile) can significantly improve the chances of successful treatment and, at the same time, minimize side effects.

To determine the genetic profile means to establish the sequence of nucleotide pairs in the DNA. This sequence determines which molecules of the protein and RNA (ribonucleic acid) will be synthesized. Epigenetic profile refers to a list of active and “silent” genes: if a DNA region or chromosomal protein is modified, then a part of genes will cease to be used.