CRAN - Campus Sciences
BP 70239 - 54506 VANDOEUVRE Cedex
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Ph. D. Project : Modeling of response to chemotherapy in diffuse low-grade gliomas
Dates : 2014/11/03 - 2018/09/30
Student: Marie BLONSKI
Manager(s) CRAN: Luc TAILLANDIER , Jean-Marie MOUREAUX
Full reference: This study will be conducted in collaboration with Meriem Ben-Abdallah (CRAN), Jean-Marie Moureaux (CRAN), Thierry Bastogne (CRAN) and Luc Taillandier (CRAN).

Diffuse low-grade gliomas (DLGGs) are glial and infiltrative brain tumors.
These tumors grow slowly and the growth kinetic could be divided into three phases: the first is an asymptomatic and silent phase with a linear rate of tumor growth (mean of 3,5 mm per year); the second phase is pauci-symptomatic with a slow kinetic (mean of 4mm per year); the third phase correspond to anaplastic transformation (high grade glioma) with a fast growth kinetic (median of anaplastic transformation of 6-7 years; median of survival 9-10 years).

The objective of this management is to delay anaplastic transformation (which remains almost ineluctable) while maintaining or even improving the quality of life of these patients.

Their current treatment remains non-standardized. However, surgery has clearly demonstrated its impact on the evolution, including survival. Chemotherapy tends to be performed earlier, especially in case of clinical and/or radiological progression. This therapeutic is well tolerated and represents an interesting option. Radiation therapy (potentially neurotoxic) is often proposed for inoperable tumors progressing after chemotherapy and / or at the time of anaplastic transformation. Some teams introduce it earlier in the strategy.

The follow-up of these patients is based on repeated radiological assessments with Magnetic Resonance Imaging MRI (frequency adapted to the tumor kinetic) allowing the estimation of the tumor volume and the growth kinetics (using the three diameters technique when only printed images are available, or using the segmentation technique when digitalized images are available). These parameters remain essential in decision making and treatment adjustment.

In our daily practice, many questions remain regarding the role of chemotherapy in DLGGs in terms of:
- Moment of initiation or discontinuation of chemotherapy
- Duration (number of cycles),
- Response (prediction of response to chemotherapy at the individual level)
- Identification of target population (which patients could better benefit from this treatment)
- Sequential processing (has a first-line chemotherapy an impact on a second-line treatment ?) ...
Other prognostic parameters (clinical, radiological, histological, molecular) are also involved in the therapeutic decision and will be integrated in the model.

The interest of this work is to study the impact of chemotherapy on tumor kinetics and to develop, based on a mathematical model, a tool for therapeutic decision (response prediction) to improve quality of care by directing the strategy at the individual level (adapted to each patient).

We will work in parallel on a MRI data compression module (image storage required for monitoring patients) and on another module concerning MRI data encryption (each assessment need an access to previous acquired data).

This project is part of a local (CRAN, SBS, BEAM), national (REG) and international (REEG) collaboration on diffuse low-grade gliomas.
Keywords: Diffuse low grade glioma. Chemotherapy. kinetic. Modelisation. Compression. Encryption
Health - Biology - Signal
Publications: hal-00199880, HAL Id : tel-00121338, J Neurooncol. 2013 ;113:267-2, Neuro Oncol. 201 ;15:595-606    + CRAN - Publications