Researchers in Spain are creating ‘digital twins’ to treat breast cancer

Researchers in Spain are creating digital models of breast cancer patients to simulate and deliver tailor-made treatment plans.

The research programme, involving 13 Spanish institutions, such as hospitals and associations, collects genetic, physiological, and behavioural data using wearable devices.

By collecting information and applying artificial intelligence (AI) to the data, they hope to improve possible treatments.

“With a real patient, you cannot make tests, you just put a treatment and then you expect the outcome,” said Miguel Quintela, oncologist and director of the Clinical Research Programme at the Spanish National Cancer Research Centre (CNIO).

“If this patient digital model is accurate enough, you can simulate millions of disease trajectories resulting from modifying one patient factor or another. So that you are able to get a number of treatment decisions, individualised for that patient that would improve patient outcome,” Quintela added.

Lucía González Cortijo, head of the medical oncology department at Quirónsalud University Hospital, said that she did not know “if they will be able to be applied immediately or in the medium-term in our patients” but said that with more research it could be possible to administer cancer medication differently.

‘World’s most prevalent cancer’

Breast cancer is the leading cause of cancer deaths in Spain among women.

In 2020, it caused 685,000 deaths globally, according to the World Health Organization.

While experts believe cancer treatments need to be adjusted and personalised for each patient, treatment guidelines available to oncologists are often designed for a handful of tumours and an "average patient".

Hairdresser Yolanda Ramos, aged 54, is one of the participants of the new “Digital Twins” project.

Ramos has triple-negative breast cancer, which is considered one of the most aggressive because the cancer cells grow and spread quickly.

In recent years, she's undergone various treatments, but they have only worked for a few months.

"When the treatment stops working, which is usually after six months, they change my treatment, and now I am on carboplatin [a chemotherapy drug] and waiting for some tests to find out if it works or not,” said Ramos.

Most participants in the project are like Ramos, patients with advanced cancers who hope the study will help others in the future.

The wearable device is connected to a smartphone app in which the patients answer questionnaires to reflect their emotions and general feelings.

The research team hopes that this will help them gain more descriptive information about how the patient is feeling than what they usually get from clinical science.

Ramos believes that it takes into account issues that oncologists don't always have time to deal with in the consultation room.

"The side effects of the chemo, how you feel, if you can get relief from the drugs, if not. If you need a psychologist," she said.

"All these things come in handy because cancer is not just about going bald, cancer is so much more," she added.

Researchers hope to publish results in a few years.

“That’s one goal, a complete treatment plan. And the second one is to be able to have an interface that somehow allows some more direct and dynamic contact care so that we detect deviations in real-time from the desirable treatment trajectory. So, rather than just realising when the treatment has failed, being able to predict this beforehand,” said Quintela.

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