Computational Trials: Unraveling Motility Phenotypes, Progression Patterns, and Treatment Options for Glioblastoma Multiforme

PLoS One. 2016 Jan 12;11(1):e0146617. doi: 10.1371/journal.pone.0146617. eCollection 2016.

Abstract

Glioblastoma multiforme is a malignant brain tumor with poor prognosis and high morbidity due to its invasiveness. Hypoxia-driven motility and concentration-driven motility are two mechanisms of glioblastoma multiforme invasion in the brain. The use of anti-angiogenic drugs has uncovered new progression patterns of glioblastoma multiforme associated with significant differences in overall survival. Here, we apply a mathematical model of glioblastoma multiforme growth and invasion in humans and design computational trials using agents that target angiogenesis, tumor replication rates, or motility. The findings link highly-dispersive, moderately-dispersive, and hypoxia-driven tumors to the patterns observed in glioblastoma multiforme treated by anti-angiogenesis, consisting of progression by Expanding FLAIR, Expanding FLAIR + Necrosis, and Expanding Necrosis, respectively. Furthermore, replication rate-reducing strategies (e.g. Tumor Treating Fields) appear to be effective in highly-dispersive and moderately-dispersive tumors but not in hypoxia-driven tumors. The latter may respond to motility-reducing agents. In a population computational trial, with all three phenotypes, a correlation was observed between the efficacy of the rate-reducing agent and the prolongation of overall survival times. This research highlights the potential applications of computational trials and supports new hypotheses on glioblastoma multiforme phenotypes and treatment options.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology*
  • Cell Hypoxia
  • Cell Movement*
  • Cell Proliferation
  • Clinical Trials as Topic*
  • Computer Simulation*
  • Disease Progression
  • Glioblastoma / drug therapy*
  • Glioblastoma / pathology*
  • Humans
  • Neoplasm Recurrence, Local / drug therapy
  • Neovascularization, Pathologic / drug therapy
  • Phenotype
  • Recurrence
  • Reproducibility of Results
  • Survival Analysis

Grants and funding

TC and OS are supported by the Laboratory of Excellence TRAIL ANR-10-LABX-57 and with financial support from the French State, managed by the French National Research Agency (ANR) in the frame of the "Investments for the future" Programme IdEx Bordeaux - CPU (ANR-10-IDEX-03-02). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.