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Gallaher, J. A.

Publications and source records attributed to Gallaher, J. A..

5 recordsLinked to original sources

The sum and the parts: dynamics of multiple and individual metastases during adaptive therapy

Evolutionary therapies, such as adaptive therapy, have shown promise in delaying treatment resistance in late-stage cancers. By alternating between drug applications and drug-free vacations, competition between sensitive and resistant cells can be exploited to maximize the time to progression. However, the optimal schedule of this dosing regimen depends on the properties of the tumor, which often are not directly measurable in clinical practice. In this work, we propose that the initial cycle of adaptive therapy can be used as a tool to probe the relevant tumor properties. We present a framework for estimating individual and collective components of a metastatic system through tumor response dynamics, which uses a system of off-lattice agent-based models to represent individual metastatic lesions within independent domains, all of which are subject to the same systemic therapy. We find that the first cycle of adaptive therapy delineates several features of the computational metastatic system: larger metastases have longer cycles; a higher proportion of drug resistant cells slows the cycles; and a faster cell turnover rate speeds up drug response time and slows the regrowth time. The number of metastases does not affect cycle times, as response dynamics are dominated by the largest tumors rather than the aggregate. In addition, the heterogeneity of the system is also a guide for therapeutic approaches: generally, systems with more between-tumor (intertumor) heterogeneity had better success with continuous therapy, while systems with more within-tumor (intratumor) heterogeneity responded better to adaptive therapy. Intertumor heterogeneity was found to correlate more with dynamics from patients with high and low Gleason scores while intratumor heterogeneity was correlated with dynamics from patients with intermediate Gleason scores.

systems biology↗

Cycling hypoxia selects for constitutive HIF stabilization

Tumors experience temporal and spatial fluctuations in oxygenation. Hypoxia inducible transcription factors (HIF-) in tumor cells are stabilized in response to low levels of oxygen and induce angiogenesis to re-supply oxygen. HIF- stabilization is typically facultative, induced by hypoxia and reduced by normoxia. In some cancers, however, HIF- stabilization becomes constitutive even under normoxia, a condition known as pseudohypoxia. Herein, we develop a mathematical model that predicts the effects of fluctuating levels of oxygen availability on stabilization of HIF- and its client proteins based on fitness. The model shows that facultative regulation of HIF- always promotes greater cell fitness than constitutive regulation. However, cell fitness is nearly identical regardless of HIF- regulation strategy when there are rapid periodic fluctuations in oxygenation. Furthermore, the model predicts that stochastic changes in oxygenation favor facultative HIF- regulation. We conclude that rapid and regular cycling of oxygenation levels selects for pseudohypoxia.

cancer biology↗

From cells to tissue: How cell scale heterogeneity impacts glioblastoma growth and treatment response

Glioblastomas are aggressive primary brain tumors known for their inter- and intratumor heterogeneity. This disease is uniformly fatal, with intratumor heterogeneity the major reason for treatment failure and recurrence. Just like the nature vs nurture debate, heterogeneity can arise from heritable or environmental influences. Whilst it is impossible to clinically separate observed behavior of cells from their environmental context, using a mathematical framework combined with multiscale data gives us insight into the relative roles of variation from inherited and environmental sources.\n\nTo better understand the implications of intratumor heterogeneity on therapeutic outcomes, we created a hybrid agent-based mathematical model that captures both the overall tumor kinetics and the individual cellular behavior. We track single cells as agents, cell density on a coarser scale, and growth factor diffusion and dynamics on a finer scale over time and space. Our model parameters were fit utilizing serial MRI imaging and cell tracking data from ex vivo tissue slices acquired from a growth-factor driven glioblastoma murine model.\n\nWhen fitting our model to serial imaging only, there was a spectrum of equally-good parameter fits corresponding to a wide range of phenotypic behaviors. This wide spectrum of in silico tumors also had a wide variety of responses to an application of an antiproliferative treatment. Recurrent tumors were generally less proliferative than pre-treatment tumors as measured via the model simulations and validated from human GBM patient histology. When fitting our model using imaging and cell scale data, we determined that heritable heterogeneity is required to capture the observed migration behavior. Further, we found that all tumors increased in size after an anti-migratory treatment, and some tumors were larger after a combination treatment than with an anti-proliferative treatment alone. Together our results emphasize the need to understand the underlying phenotypes and tumor heterogeneity in designing therapeutic regimens.

cancer biology↗

Connecting the Microenvironmental Niche to Treatment Response in Ovarian Cancer

Ovarian cancer has the highest mortality rate of all gynecologic cancers, which may be attributed to an often late stage diagnosis, when the cancer is already metastatic, and rapid development of treatment resistance. We propose that the metastatic disease could be better characterized by observing interactions within the microenvironmental niche of the primary site that shapes the tumors early phenotypic progression. We present a mechanistic mathematical model of ovarian cancer that considers spatial interactions between tumor cells and several key stromal components. We demonstrate how spatial biomarker imaging data from the primary tumor can be analyzed to define a patient-specific microenvironment in the mathematical model. We then show preliminary results, using this model, that demonstrate how differences in the niche composition of a tumor affects phenotypic evolution and treatment response.

cancer biology↗

Adaptive Therapy For Heterogeneous Cancer: Exploiting Space And Trade-Offs In Drug Scheduling

Treatment of advanced cancers has benefited from new agents that supplement or bypass conventional therapies. However, even effective therapies fail as cancer cells deploy a wide range of resistance strategies. We propose that evolutionary dynamics ultimately determine survival and proliferation of resistant cells, therefore evolutionary strategies should be used with conventional therapies to delay or prevent resistance. Using an agent-based framework to model spatial competition among sensitive and resistant populations, we apply anti-proliferative drug treatments to varying ratios of sensitive and resistant cells. We compare a continuous maximum tolerated dose schedule with an adaptive schedule aimed at tumor control through competition between sensitive and resistant cells. We find that continuous treatment cures mostly sensitive tumors, but with any resistant cells, recurrence is inevitable. We identify two adaptive strategies that control heterogeneous tumors: dose modulation controls most tumors with less drug, while a more vacation-oriented schedule can control more invasive tumors.

cancer biology↗