To obtain an accurate predictive model we found a different PSA measurements

complexity of the system call for mathematical modeling to formally describe and quantify the co-development of malignancy and immunity, and to predict strategies for additional immune manipulation to Salvianolic-acid-B enhance clinical outcomes. The feasibility of this approach is rooted in the role mathematical models have played in providing non-intuitive insights into tumor growth, progression, and treatment. We have developed a simple mathematical model, individualized it by fitting to PSA values recorded in individual patients before and during vaccination therapy, validated the model by subsequent individual PSA values, and used the results to predict the immediate response of PSA levels to modifications of vaccine dose or administration schedule. The model was remarkably successful in predicting PSA level changes in 12 out of 15 analyzed treatment-responsive patients. The manifested robustness of the fits was not compromised by the model simplicity, encompassing no more than four patient-specific parameters, with other parameters being derived from preclinical and clinical information collected from disparate published sources. Apparently, a generic representation of the interplay of immune activation and suppression suffices to describe clinical responses without the need to consider all individual mechanistic elements participating in immune regulation separately. Derivation of patient-specific parameters from training sets and the successful validation of individualized models ascertain the predictive power of our model. For three patients, validation was unsuccessful because of the Isoastragaloside-II non-monotonous behavior of PSA levels at the end of vaccination course. Of note, deviation of the course of PSA levels from monotony could indicate unpredicted significant changes in the dynamic relationships between immunity and the tumor. It is tempting to speculate that this took place because vaccination broke down tumor progression. As responses to vaccination differed among the patients significantly, a major motive for this study was to ascertain the feasibility of improving individualized treatment. Having validated the individually parameterized models of the effect of vaccination, we tested whether the model can suggest modifications in vaccine dose or administration schedule needed to stabilize PSA levels. The suggested changes also differed among patients, a finding emphasizing the potential value of testing individualized vaccination protocols in clinical trials. It is noteworthy that modifications of either the size of vaccine dose or the interval between doses could result in comparable tumor responses, allowing considerable flexibility in the choice of clinically and logistically most feasible protocols. Thus, the benefit of the method is that it could identify the patients who will not respond to therapy and enhance treatment efficacy for those who will.

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