Abstract
Tissue necrosis and calcification significantly affect cancer progression and clinical treatment decisions. Necrosis and calcification are inherently multiscale processes, operating at molecular to tissue scales with time scales ranging from hours to months. This chapter details key insights we have gained through mechanistic continuum and discrete multiscale models, including the first modeling of necrotic cell swelling, lysis, and calcification. Among our key findings: necrotic volume loss contributes to steady tumor sizes but can destabilize tumor morphology; steady necrotic fractions can emerge even during unstable growth; necrotic volume loss is responsible for linear ductal carcinoma in situ (DCIS) growth; fast necrotic cell swelling creates mechanical tears at the perinecrotic boundary; multiscale interactions give rise to an age-structured, stratified necrotic core; and mechanistic, patient-calibrated DCIS modeling allows us to assess our working biological assumptions and better interpret pathology and mammography. We finish by outlining our integrative computational oncology approach to developing computational tools that we hope will one day assist clinicians and patients in their treatment decisions.
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Acknowledgments
PM and SM thank the National Institutes of Health for the Physical Sciences Oncology Center grant 5U54CA143907 for Multi-scale Complex Systems Transdisciplinary Analysis of Response to Therapy–MC-START. PM thanks the USC James H. Zumberge Research and Innovation Fund (2012 Large Interdisciplinary Award) for support through the new Consortium for Integrative Computational Oncology (CICO), and the USC Undergraduates Research Associate Program (URAP) for student support. JL gratefully acknowledges partial support from the National Institutes of Health, National Cancer Institute, for funding through grants 1RC2CA148493-01, P50GM76516 for a Center of Excellence in Systems Biology at the University of California, Irvine, and P30CA062203 for the Chao Comprehensive Cancer Center at the University of California, Irvine. JL also acknowledges support from the National Science Foundation, Division of Mathematical Sciences.
PM thanks David Agus (USC Center for Applied Molecular Medicine); Andrew Evans, Jordan Lee, Colin Purdie, and Alastair Thompson (U. of Dundee/NHS Tayside); and Paul Newton (USC Department of Aerospace and Mechanical Engineering) for enlightening discussions. PM thanks Andrew Evans for Fig. 13. The authors thank Ying Chen (U. California at Irvine) for Fig. 14.
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Macklin, P., Mumenthaler, S., Lowengrub, J. (2013). Modeling Multiscale Necrotic and Calcified Tissue Biomechanics in Cancer Patients: Application to Ductal Carcinoma In Situ (DCIS). In: Gefen, A. (eds) Multiscale Computer Modeling in Biomechanics and Biomedical Engineering. Studies in Mechanobiology, Tissue Engineering and Biomaterials, vol 14. Springer, Berlin, Heidelberg. https://doi.org/10.1007/8415_2012_150
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