Multimodality imaging and mathematical modelling of drug delivery to glioblastomas

Patients diagnosed with glioblastoma, an aggressive brain tumour, have a poor prognosis, with a median overall survival of less than 15 months. Vasculature within these tumours is typically abnormal, with increased tortuosity, dilation and disorganization, and they typically exhibit a disrupted blood–brain barrier (BBB). Although it has been hypothesized that the ‘normalization’ of the vasculature resulting from anti-angiogenic therapies could improve drug delivery through improved blood flow, there is also evidence that suggests that the restoration of BBB integrity might limit the delivery of therapeutic agents and hence their effectiveness. In this paper, we apply mathematical models of blood flow, vascular permeability and diffusion within the tumour microenvironment to investigate the effect of these competing factors on drug delivery. Preliminary results from the modelling indicate that all three physiological parameters investigated—flow rate, vessel permeability and tissue diffusion coefficient—interact nonlinearly to produce the observed average drug concentration in the microenvironment.

[1]  A. Omuro Exploring multi-targeting strategies for the treatment of gliomas. , 2008, Current opinion in investigational drugs.

[2]  S. McDougall,et al.  Dynamics of Angiogenesis During Wound Healing: A Coupled In Vivo and In Silico Study , 2011, Microcirculation.

[3]  Mark A. J. Chaplain,et al.  The effect of interstitial pressure on therapeutic agent transport: coupling with the tumor blood and lymphatic vascular systems. , 2014, Journal of theoretical biology.

[4]  M A J Chaplain,et al.  Dynamics of angiogenesis during murine retinal development: a coupled in vivo and in silico study , 2012, Journal of The Royal Society Interface.

[5]  B. Rosen,et al.  Advanced magnetic resonance imaging of the physical processes in human glioblastoma. , 2014, Cancer research.

[6]  R K Jain,et al.  Barriers to drug delivery in solid tumors. , 1994, Scientific American.

[7]  A. Dale,et al.  Frontiers in Optical Imaging of Cerebral Blood Flow and Metabolism , 2012, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[8]  Emiri T. Mandeville,et al.  Cerebral blood oxygenation measurement based on oxygen-dependent quenching of phosphorescence. , 2011, Journal of visualized experiments : JoVE.

[9]  Min Wu,et al.  The effect of interstitial pressure on tumor growth: coupling with the blood and lymphatic vascular systems. , 2013, Journal of theoretical biology.

[10]  Bruce R. Rosen,et al.  Vessel Architectural Imaging Identifies Cancer Patient Responders to Anti-angiogenic Therapy , 2013, Nature Medicine.

[11]  S. Grossman,et al.  How critical is the blood-brain barrier to the development of neurotherapeutics? , 2015, JAMA neurology.

[12]  Anna Devor,et al.  Oxygen advection and diffusion in a three- dimensional vascular anatomical network. , 2008, Optics express.

[13]  J. Uhm An Integrated Genomic Analysis of Human Glioblastoma Multiforme , 2009 .

[14]  J. Hooker,et al.  An efficient and practical radiosynthesis of [11C]temozolomide. , 2012, Organic letters.

[15]  Mauro Ferrari,et al.  Integrated intravital microscopy and mathematical modeling to optimize nanotherapeutics delivery to tumors. , 2012, AIP advances.

[16]  B. Rosen,et al.  Improved tumor oxygenation and survival in glioblastoma patients who show increased blood perfusion after cediranib and chemoradiation , 2013, Proceedings of the National Academy of Sciences.

[17]  P. LaViolette,et al.  Volumetric analysis of functional diffusion maps is a predictive imaging biomarker for cytotoxic and anti-angiogenic treatments in malignant gliomas , 2011, Journal of Neuro-Oncology.

[18]  R. Kirshner,et al.  The Earth's elements. , 1994, Scientific American.

[19]  Tracy T Batchelor,et al.  Infiltrative patterns of glioblastoma spread detected via diffusion MRI after treatment with cediranib. , 2010, Neuro-oncology.

[20]  S. McDougall,et al.  Mathematical modelling of dynamic adaptive tumour-induced angiogenesis: clinical implications and therapeutic targeting strategies. , 2006, Journal of theoretical biology.

[21]  F. Turkheimer,et al.  A new model for prediction of drug distribution in tumor and normal tissues: pharmacokinetics of temozolomide in glioma patients. , 2009, Cancer research.

[22]  Amy J. Blatt,et al.  A New Model , 2015 .

[23]  R K Jain,et al.  Tumor angiogenesis and interstitial hypertension. , 1996, Cancer research.

[24]  Yazhou Wang,et al.  Transport barriers and strategies of antitumor nanocarriers delivery system. , 2013, Journal of biomedical materials research. Part A.

[25]  R. Jain,et al.  Role of extracellular matrix assembly in interstitial transport in solid tumors. , 2000, Cancer research.

[26]  A. Dale,et al.  Longitudinal Restriction Spectrum Imaging Is Resistant to Pseudoresponse in Patients with High-Grade Gliomas Treated with Bevacizumab , 2013, American Journal of Neuroradiology.

[27]  Tracy T Batchelor,et al.  Increased survival of glioblastoma patients who respond to antiangiogenic therapy with elevated blood perfusion. , 2012, Cancer research.

[28]  M. Lubberink,et al.  Rapid decrease in delivery of chemotherapy to tumors after anti-VEGF therapy: implications for scheduling of anti-angiogenic drugs. , 2012, Cancer cell.

[29]  R. Mirimanoff,et al.  Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. , 2009, The Lancet. Oncology.

[30]  Patrick Y Wen,et al.  Therapeutic advances in the treatment of glioblastoma: rationale and potential role of targeted agents. , 2006, The oncologist.

[31]  Santosh Kesari,et al.  Malignant gliomas in adults. , 2008, The New England journal of medicine.

[32]  Rakesh K. Jain,et al.  Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy , 2001, Nature Medicine.

[33]  Marjolijn N Lub-de Hooge,et al.  Bevacizumab-induced normalization of blood vessels in tumors hampers antibody uptake. , 2013, Cancer research.

[34]  M. Chaplain,et al.  A mathematical model for the diffusion of tumour angiogenesis factor into the surrounding host tissue. , 1991, IMA journal of mathematics applied in medicine and biology.

[35]  S. McDougall,et al.  Mathematical modelling of flow through vascular networks: Implications for tumour-induced angiogenesis and chemotherapy strategies , 2002, Bulletin of mathematical biology.

[36]  Paul Kinahan,et al.  Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. , 2010, Seminars in ultrasound, CT, and MR.

[37]  Triantafyllos Stylianopoulos,et al.  Delivery of molecular and nanoscale medicine to tumors: transport barriers and strategies. , 2011, Annual review of chemical and biomolecular engineering.

[38]  M A J Chaplain,et al.  A Hybrid Discrete-Continuum Mathematical Model of Pattern Prediction in the Developing Retinal Vasculature , 2012, Bulletin of mathematical biology.

[39]  David A. Boas,et al.  Validation of the hypercapnic calibrated fMRI method using DOT–fMRI fusion imaging , 2014, NeuroImage.

[40]  R. Jain Normalizing tumor microenvironment to treat cancer: bench to bedside to biomarkers. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[41]  Anna Devor,et al.  Quantifying the Microvascular Origin of BOLD-fMRI from First Principles with Two-Photon Microscopy and an Oxygen-Sensitive Nanoprobe , 2015, The Journal of Neuroscience.

[42]  David A. Boas,et al.  Blockface histology with optical coherence tomography: A comparison with Nissl staining , 2014, NeuroImage.

[43]  J. Knisely,et al.  Concurrent chemoradiotherapy versus radiotherapy alone for “biopsy‐only” glioblastoma multiforme , 2016, Cancer.

[44]  David A Boas,et al.  Multimodal optical imaging system for in vivo investigation of cerebral oxygen delivery and energy metabolism. , 2015, Biomedical optics express.