Fighting Glioblastoma with Mathematical Modeling.

• Author: McKenzie, Megan
• Position: Medicine & Health - Mayo Clinic oncologist Kristin Swanson talks about using math to study glioblastoma - Interview

"What is needed are tools to predict what the disease is going to do in each patient.... Basically ... a tumor forecasting center."

ENTERING the Mathematical Neuro-Oncology lab at Mayo Clinic's location in Scottsdale, Ariz., is like walking onto the bridge of a ship in some fictional universe. There is a definite "Star Trek" vibe. "Yes, 'Star Trek' is good," laughs oncologist Kristin Swanson, "but I like 'Big Bang Theory.' I kind of joke that that's what my lab feels like."

Geeky or not, she and her team use math to study glioblastoma, a type of cancer that starts in the glial cells of the brain and spine. Normally, these cells support and protect neurons, but when they become cancerous, they divide without stopping, forming tumors that insinuate themselves into the brain. About 80% of malignant brain tumors are gliomas.

"It's what John McCain passed away from, and Teddy Kennedy and Beau Biden. It's a particularly aggressive tumor that has a median survival of about 14 months, and that rate has barely moved over the last 50 years. It's just an unbelievably challenging disease," says Swanson, co-director of the Precision Neuro-Therapeutics Innovation Program; director of the Mathematical Neuro-Oncology lab; and professor and vice chair of Research in Neurosurgery.

By applying her imagination and grasp of math, and channeling her own sense of loss after a family member's death from cancer, Swanson is making sense of vast datasets collected from thousands of patients with brain tumors. Employing artificial intelligence (AI) and other mathematical modeling methods, she is getting to know glioblastoma at a whole new level--its texture, density, direction of growth, and rate of invasion while making patient-specific maps of tumors to predict which treatments will work best to terminate them.

Although the standard treatment for glioblastoma is aggressive--surgery followed by chemotherapy and radiation--tumors respond in widely different ways. Only 40% of patients survive for at least one year, but almost six percent live much longer, more like five years. So, when it comes to predicting glioma growth, average does not mean much.

Cancer care teams have had meager means by which to gauge what each patient might expect. Worse, they have minimal evidence to indicate if a treatment is affecting tumor growth significantly. A person's glioma may slow its growth under a drug regimen, or after surgery or radiation, but it has been impossible to figure out how significant that reduction might be. Without treatment, would the tumor have doubled in size, tripled, or quadrupled...