In silico oncology en route to clinical translation

Cancer has been designated as one of the key research and innovation missions of the next framework programme Horizon Europe (2021-2027). These missions are high-ambition, high profile initiatives, to find solutions to some of the major challenges faced by European citizens, with a clear target that captures the imagination of citizens at large.

Within this context, the emerging domain of in silico oncology, being a branch of the broader in silico medicine (https://en.wikipedia.org/wiki/In_silico_medicine, https://ec.europa.eu/digital-singlemarket/en/news/silico-medicine-will-be-future ) has already demonstrated its great potential for the personalization of cancer treatment. According to this approach, treatment individualization is to be based on experimentation in silico (i.e. on the computer) using complex mechanistic multiscale mathematical and computational models of tumour growth and response to treatment in conjunction with pertinent multiscale data of the patient (imaging, histological, molecular etc. data). Following a series of great joint achievements and innovations made in the domain of in silico oncology by several European Commission funded projects such as ACGT, ContraCancrum, TUMOR, p-medicine, MyHealthAvatar, Dr Therapat and CHIC (https://cordis.europa.eu/result/rcn/86061_en.html, https://ec.europa.eu/digital-singlemarket/en/news/great-achievements-eu-funded-chic-project, https://www.innoradar.eu/innovation/23061, https://www.innoradar.eu/innovation/23058 ), in silico oncology is currently entering a new and highly promising phase of clinical adaptation and validation, en route to its clinical translation. 

Norbert Graf, Professor of Paediatric Oncology and Haematology, Director of the homonymous clinic of the University of Saarland (USAAR), Germany, and Chairman of the Renal Tumour Study Group (SIOP-RTSG) of the International Society of Paediatric Oncology (SIOP), and Georgios Stamatakos, Research Professor of Biological Systems Analysis and Simulation at the Institute of Communication and Computer Systems (ICCS) - National Technical University of Athens (NTUA), Greece, Director of the In Silico Oncology and In Silico Medicine Group, ICCS-NTUA, and Visiting Professor at the Medical School of USAAR, Germany, have re-joined forces and are coordinating the respective research groups in Homburg and Athens, endeavouring to both retrospectively and prospectively validate the Nephroblastoma Oncosimulator. To this end, a special and crucial role is played by Eckart Meese, Professor of Human Genetics and Director of the Human Genetics Institute, Medical School, USAAR. 

In order to fully comply with the legal and ethical restrictions imposed by the EU General Data Protection Regulation (GDPR), a new infrastructure is being built within the University Hospital of Saarland able to support the collection, storage, retrieval, curation and exploitation of multiscale data generated during nephroblastoma treatment and also execute the multiscale mechanistic simulation models making up the Nephroblastoma Oncosimulator within the hospital environment. 

Selecting the Medical School and the University Hospital of USAAR as the primary setting for this new phase of the Neprhoblastoma Oncosimulator clinical translation procedure has been a strategic decision that perfectly matches the key requirements for a successful retrospective and prospective clinical validation outcome. In this context, following an invitation made by USAAR and initiated by Norbert Graf and Eckart Meese, Georgios Stamatakos is currently working at USAAR and will be doing so till the middle of September 2019. The reason behind this development is for the bilateral team to exploit the great potential that physical collaboration offers in order to jointly best plan and design the next critical steps of the Oncosimulator clinical translation procedure. Norbert Graf is planning to integrate the prospective clinical validation of the Nephroblastoma Oncosimulator into the new SIOP clinical trial for nephroblastoma, of which he is the chairman. The implementation of such an action is expected to greatly boost the effectiveness of the endeavour and hopefully accelerate the clinical utilization of the Nephroblastoma Oncosimulator as both a patient individualized decision support system and an oncological in silico trial platform. 

Furthermore, a successful clinical translation outcome could serve as a guiding paradigm for the clinical translation of Oncosimulators addressing other cancer types. Last but not least, a successful outcome of the clinical validation endeavour would also clearly contribute to the gradual transformation of medicine, and in particular oncology, into an exact and precise mathematical and computational science, pretty similar to any physical science dealing with essentially non living matter, as Georgios Stamatakos maintains.