Mathematical modeling of the dynamics of the bladder cancer and the immune response applied to a patient: Evolution and short-term prediction

[EN] Bladder cancer is one of the most common malignant diseases in the urinary system and a highly aggressive neoplasm. The prognosis is not favorable usually, and its evolution for particular patients is very difficult to find out. In this paper, we propose a dynamic mathematical model that describes the bladder tumor growth and the immune response evolution. This model is customized for a single patient, determining appropriate model parameter values via model calibration. Due to the uncertainty of the tumor evolution, using the calibrated model parameters, we predict the tumor size and the immune response evolution over the next few months assuming three different scenarios: favorable, neutral, and unfavorable. In the former, it is not expected any trace of the cancer in the middle of September 2018 (after 16 mo). In the neutral scenario, at the same date, a 7- to 8-mm tumor is expected. In the worst case, a 40-mm tumor is expected. The patient was cited on 10 September 2018 to check the tumor size, and according to the doctors, there was no sign of recurrence. It seems that we are in the favorable scenario. The patient will be called again for follow-up in mid-2019.This work has been supported by the Ministerio de Economía, Industria y Competitividad grant MTM2017-89664-P.Burgos-Simon, C.; García-Medina, N.; Martínez-Rodríguez, D.; Villanueva Micó, RJ. (2019). Mathematical modeling of the dynamics of the bladder cancer and the immune response applied to a patient: Evolution and short-term prediction. Mathematical Methods in the Applied Sciences. 42(17):5746-5757. https://doi.org/10.1002/mma.5536S574657574217Official Site for Spanish Medic Oncology Society.https://www.seom.org. Accessed: 25/09/2018.Greenlee, R. T., Hill-Harmon, M. B., Murray, T., & Thun, M. (2001). Cancer Statistics, 2001. CA: A Cancer Journal for Clinicians, 51(1), 15-36. doi:10.3322/canjclin.51.1.15Holmang, S., Hedelin, H., Anderstrom, C., & Johansson, S. L. (1995). The Relationship Among Multiple Recurrences, Progression and Prognosis of Patients with Stages TA and T1 Transitional Cell Cancer of the Bladder Followed for at least 20 years. Journal of Urology, 153(6), 1823-1827. doi:10.1016/s0022-5347(01)67321-xRedelman-Sidi, G., Glickman, M. S., & Bochner, B. H. (2014). The mechanism of action of BCG therapy for bladder cancer—a current perspective. Nature Reviews Urology, 11(3), 153-162. doi:10.1038/nrurol.2014.15Bladder Cancer Treatment (PDQ)‐Health Professional Version.https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq. Accessed: 25/09/2018.Bladder Cancer Treatment (PDQ)‐Patient Version.https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Accessed: 25/09/2018.Official Site for Hospital Universitari i Politècnic La Fe Valencia Spain.http://www.hospital-lafe.com. Accessed: 25/09/2018.Hanahan, D., & Weinberg, R. A. (2011). Hallmarks of Cancer: The Next Generation. Cell, 144(5), 646-674. doi:10.1016/j.cell.2011.02.013Dong, H., Strome, S. E., Salomao, D. R., Tamura, H., Hirano, F., Flies, D. B., … Chen, L. (2002). Tumor-associated B7-H1 promotes T-cell apoptosis: A potential mechanism of immune evasion. Nature Medicine, 8(8), 793-800. doi:10.1038/nm730Fernandez, N. C., Lozier, A., Flament, C., Ricciardi-Castagnoli, P., Bellet, D., Suter, M., … Zitvogel, L. (1999). Dendritic cells directly trigger NK cell functions: Cross-talk relevant in innate anti-tumor immune responses in vivo. Nature Medicine, 5(4), 405-411. doi:10.1038/7403Factsheet of OncoTICE 2 − 8 × 108UFC powder for suspension intravesical (in Spanish).https://www.aemps.gob.es/cima/pdfs/es/ft/61377/61377_ft.pdf. Accessed: 25/09/2018

Extramedullary myeloma in an HIV-seropositive subject. Literature review and report of an unusual case

Myeloma is characterized by monoclonal bone marrow plasmacytosis, the presence of M-protein in serum and/or in urine and osteolytic bone lesions. HIV-seropositive subjects with myeloma are younger at the time of diagnosis of the tumour and usually the myeloma has a more aggressive clinical course than it does in HIV-seronegative subjects

Saccadic latency in hepatic encephalopathy: a pilot study

Hepatic encephalopathy is a common complication of cirrhosis. The degree of neuro-psychiatric impairment is highly variable and its clinical staging subjective. We investigated whether eye movement response times—saccadic latencies—could serve as an indicator of encephalopathy. We studied the association between saccadic latency, liver function and paper- and pencil tests in 70 patients with cirrhosis and 31 patients after liver transplantation. The tests included the porto-systemic encephalopathy (PSE-) test, critical flicker frequency, MELD score and ammonia concentration. A normal range for saccades was established in 31 control subjects. Clinical and biochemical parameters of liver, blood, and kidney function were also determined. Median saccadic latencies were significantly longer in patients with liver cirrhosis when compared to patients after liver transplantation (244 ms vs. 278 ms p < 0.001). Both patient groups had prolonged saccadic latency when compared to an age matched control group (175 ms). The reciprocal of median saccadic latency (μ) correlated with PSE tests, MELD score and critical flicker frequency. A significant correlation between the saccadic latency parameter early slope (σE) that represents the prevalence of early saccades and partial pressure of ammonia was also noted. Psychometric test performance, but not saccadic latency, correlated with blood urea and sodium concentrations. Saccadic latency represents an objective and quantitative parameter of hepatic encephalopathy. Unlike psychometric test performance, these ocular responses were unaffected by renal function and can be obtained clinically within a matter of minutes by non-trained personnel