Breast cancer and the black swan

Retsky, Michael; Demicheli, Romano; Hrushesky, William J. M.; James, Ted A.; Rogers, Rick A.; Baum, Michael; Vaidya, JS; Erhabor, O; Forget, Patrice

doi:10.3332/ecancer.2020.1050

Cited by 4 publications

(6 citation statements)

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“…(2) Increased local and systemic production of growth and angiogenesis factors required for the healing of injury caused by radiation treatment. For a discussion of the role of wounding in promotion of metastasis, see [36] and references therein. (3) Transient inflammation and temporary immunosuppression that may cause metastases to escape from dormancy and evade immune surveillance.…”

Section: Discussionmentioning

confidence: 99%

Paradoxical Effects of Tumor Shrinkage on Long-Term Survival of Cancer Patients

Hanin

2020

Front. Appl. Math. Stat.

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In this article, we challenge the existing paradigm that greater tumor shrinkage at the end of treatment leads to longer patient survival. In particular, we identify biological conditions under which the exact opposite is true. A central role in our argument about the paradoxical effect of tumor shrinkage is played by the emergence and self-selection of subpopulations of increasingly faster proliferating cancer cells. This evolutionary factor is often at work during post-treatment tumor regrowth and has a decidedly negative impact on patient survival. We analyze various patterns of post-treatment tumor dynamics and show that if the clones generated by cancer cells present at the end of treatment or the start of a treatment break evolve independently then greater tumor shrinkage leads to progressive enrichment of the re-growing tumor with faster proliferating cells. Importantly, greater tumor shrinkage favors independent clonal expansion. Our findings explain numerous clinical cases where initial tumor shrinkage to undetectable levels was promptly followed by an aggressive tumor recurrence. They also suggest that indiscriminate use of tumor shrinkage as surrogate endpoint in clinical trials should be discouraged.

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Section: Discussionmentioning

confidence: 99%

Paradoxical Effects of Tumor Shrinkage on Long-Term Survival of Cancer Patients

Hanin

2020

Front. Appl. Math. Stat.

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“…Growth plateaus were observed for breast cancer suggesting irregular growth kinetics 11 , 28 . Regularity is not a universal characteristic of malignant growth.…”

Section: Risk Increases With Time Speculations On Risk- and Number Tmentioning

confidence: 99%

“…For the COVID-19 pandemics, τ is about 5 d and for cancer cell growth, τ is between 100 and 300 d. Figure 5 a shows that after a period of dormancy the tumor can be triggered to disseminate very fast, the so-called growth spurt. Among others, angiogenesis 20 and inflammations 28 are two candidates at the origin of a growth spurt in cancer. A weakening of the behavior rules can trigger a second wave in a pandemics.…”

Section: Risk Increases With Time Speculations On Risk- and Number Tmentioning

confidence: 99%

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Similarities between pandemics and cancer in growth and risk models

Vandamme

Hingh

Fonseca

et al. 2021

Sci Rep

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Cancer and pandemics are leading causes of death globally, with severe socioeconomic repercussions. To better understand these repercussions, we investigate similarities between pandemics and cancer and describe the limited growth in number of infections or cancer cells, using mathematical models. For a pandemic, the analysis shows that in most cases, the initial fast growth is followed by a slower decay in the recovery phase. The risk of infection increases due to the airborne virus contact crossing a risk-threshold. For cancers caused by carcinogens, the increasing risk with age and absorbed dose of toxins that cross a risk-threshold, may lead to the disease onset. The time scales are different for both causes of death: years for cancer development and days to weeks for contact with airborne viruses. Contamination by viruses is on a time scale of seconds or minutes. The risk-threshold to get ill and the number-threshold in cancer cells or viruses, may explain the large variability in the outcome. The number of infected persons per day is better represented in log–lin plots instead of the conventional lin–lin plots. Differences in therapies are discussed. Our mathematical investigation between cancer and pandemics reveals a multifactorial correlation between both fragilities and brings us one step closer to understand, timely predict and ultimately diminish the socioeconomic hurdle of both cancer and pandemics.

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“…In a recent paper, my colleagues and I proposed a method to prevent early relapses in breast cancer [ 1 ]. (For a well-done graphic perspective, see the Moss report [ 2 ].)…”

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confidence: 99%