Physiological random processes in precision cancer therapy.

Many different physiological processes affect the growth of malignant lesions and their response to therapy. Each of these processes is spatially and genetically heterogeneous; dynamically evolving in time; controlled by many other physiological processes, and intrinsically random and unpredictable. The objective of this paper is to show that all of these properties of cancer physiology can be treated in a unified, mathematically rigorous way via the theory of random processes. We treat each physiological process as a random function of position and time within a tumor, defining the joint statistics of such functions via the infinite-dimensional characteristic functional. The theory is illustrated by analyzing several models of drug delivery and response of a tumor to therapy. To apply the methodology to precision cancer therapy, we use maximum-likelihood estimation with Emission Computed Tomography (ECT) data to estimate unknown patient-specific physiological parameters, ultimately demonstrating how to predict the probability of tumor control for an individual patient undergoing a proposed therapeutic regimen.