Pattern Formation as a Resilience Mechanism in Cancer Immunotherapy

Mathematical and computational modelling in oncology has played an increasingly important role in not only understanding the impact of various approaches to treatment on tumour growth, but in optimizing dosing regimens and aiding the development of treatment strategies. However, as with all modelling, only an approximation is made in the description of the biological and physical system. Here we show that tissue-scale spatial structure can have a profound impact on the resilience of tumours to immunotherapy using a classical model incorporating IL-2 compounds and effector cells as treatment parameters. Using linear stability analysis, numerical continuation, and direct simulations, we show that diffusing cancer cell populations can undergo pattern-forming (Turing) instabilities, leading to spatially-structured states that persist far into treatment regimes where the corresponding spatially homogeneous systems would uniformly predict a cancer-free state. These spatially-patterned states persist in a wide range of parameters, as well as under time-dependent treatment regimes. Incorporating treatment via domain boundaries can increase this resistance to treatment in the interior of the domain, further highlighting the importance of spatial modelling when designing treatment protocols informed by mathematical models. Counter-intuitively, this mechanism shows that increased effector cell mobility can increase the resilience of tumours to treatment. We conclude by discussing practical and theoretical considerations for understanding this kind of spatial resilience in other models of cancer treatment, in particular those incorporating more realistic spatial transport.