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Research article Special Issues

Dynamics and implications of models for intermittent androgen suppression therapy

  • Received: 11 October 2018 Accepted: 12 October 2018 Published: 11 December 2018
  • In this paper, we formulate a three cell population model of intermittent androgen suppression therapy for cancer patients to study the treatment resistance development. We compare it with other models that have different underlying cell population structure using patient prostate specific antigen (PSA) and androgen data sets. Our results show that in the absence of extensive data, a two cell population structure performs slightly better in replicating and forecasting the dynamics observed in clinical PSA data. We also observe that at least one absorbing state should be present in the cell population structure of a plausible model for it to produce treatment resistance under continuous hormonal therapy. This suggests that the heterogeneity of prostate cancer cell population can be represented by two types of cells differentiated by their level of dependence on androgen, where the two types are linked via an irreversible transformation.

    Citation: Tin Phan, Changhan He, Alejandro Martinez, Yang Kuang. Dynamics and implications of models for intermittent androgen suppression therapy[J]. Mathematical Biosciences and Engineering, 2019, 16(1): 187-204. doi: 10.3934/mbe.2019010

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  • In this paper, we formulate a three cell population model of intermittent androgen suppression therapy for cancer patients to study the treatment resistance development. We compare it with other models that have different underlying cell population structure using patient prostate specific antigen (PSA) and androgen data sets. Our results show that in the absence of extensive data, a two cell population structure performs slightly better in replicating and forecasting the dynamics observed in clinical PSA data. We also observe that at least one absorbing state should be present in the cell population structure of a plausible model for it to produce treatment resistance under continuous hormonal therapy. This suggests that the heterogeneity of prostate cancer cell population can be represented by two types of cells differentiated by their level of dependence on androgen, where the two types are linked via an irreversible transformation.


    In 1960, Opial [12] established the following inequality:

    Theorem A Suppose fC1[0,h] satisfies f(0)=f(h)=0 and f(x)>0 for all x(0,h). Then the inequality holds

    h0|f(x)f(x)|dxh4h0(f(x))2dx, (1.1)

    where this constant h/4 is best possible.

    Many generalizations and extensions of Opial's inequality were established [2,4,5,6,7,8,9,10,11,15,16,17,18,19]. For an extensive survey on these inequalities, see [13]. Opial's inequality and its generalizations and extensions play a fundamental role in the ordinary and partial differential equations as well as difference equation [2,3,4,6,7,9,10,11,17]. In particular, Agarwal and Pang [3] proved the following Opial-Wirtinger's type inequalities.

    Theorem B Let λ1 be a given real number, and let p(t) be a nonnegative and continuous function on [0,a]. Further, let x(t) be an absolutely continuous function on [0,a], with x(0)=x(a)=0. Then

    a0p(t)|x(t)|λdt12a0[t(at)](λ1)/2p(t)dta0|x(t)|λdt. (1.2)

    The first aim of the present paper is to establish Opial-Wirtinger's type inequalities involving Katugampola conformable partial derivatives and α-conformable integrals (see Section 2). Our result is given in the following theorem, which is a generalization of (1.2).

    Theorem 1.1 Let λ1 be a real number and α(0,1], and let p(s,t) be a nonnegative and continuous functions on [0,a]×[0,b]. Further, let x(s,t) be an absolutely continuous function and Katugampola partial derivable on [0,a]×[0,b], with x(s,0)=x(0,t)=x(0,0)=0 and x(a,b)=x(a,t)=x(s,b)=0. If p>1, 1p+1q=1 Then

    a0b0p(s,t)|x(s,t)|λdαsdαtp+qpq(1α2)λ1(a0b0Γabpqλα(s,t)p(s,t)dαsdαt)
    ×a0b0|2st(x)α2(s,t)|λdαsdαt, (1.3)

    where

    Γabpqλα(s,t)={(st)1/p[(as)(bt)]1/q}α(λ1).

    Remark 1.1 Let x(s,t) reduce to s(t) and with suitable modifications, and p=q=2 and α=1, (1.3) become (1.2).

    Theorem C Let λ1 be a given real number, and let p(t) be a nonnegative and continuous function on [0,a]. Further, let x(t) be an absolutely continuous function on [0,a], with x(0)=x(a)=0. Then

    a0p(t)|x(t)|λdt12(a2)λ1(a0p(t)dt)a0|x(t)|λdt. (1.4)

    Another aim of this paper is to establish the following inequality involving Katugampola conformable partial derivatives and α-conformable integrals. Our result is given in the following theorem.

    Theorem 1.2 Let j=1,2 and λ1 be a real number, and let pj(s,t) be a nonnegative and continuous functions on [0,a]×[0,b]. Further, let xj(s,t) be an absolutely continuous function and Katugampola partial derivable on [0,a]×[0,b], with xj(s,0)=xj(0,t)=xj(0,0)=0 and xj(a,b)=xj(a,t)=xj(s,b)=0. Then for α(0,1]

    a0b0(p1(s,t)|x1(s,t)|λ+p2(s,t)|x2(s,t)|λ)dαsdαt
    12λ(1α2)λ1[(a0b0(st)α(λ1)p1(s,t)dαsdαt)a0b0|2st(x1)α2(s,t)|λdαsdαt
    +(a0b0(st)α(λ1)p2(s,t)dαsdαt)a0b0|2st(x2)α2(s,t)|λdαsdαt]. (1.5)

    Here, let's recall the well-known Katugampola derivative formulation of conformable derivative of order for α(0,1] and t[0,), given by

    Dα(f)(t)=limε0f(teεtα)f(t)ε, (2.1)

    and

    Dα(f)(0)=limt0Dα(f)(t), (2.2)

    provided the limits exist. If f is fully differentiable at t, then

    Dα(f)(t)=t1αdfdt(t).

    A function f is α-differentiable at a point t0, if the limits in (2.1) and (2.2) exist and are finite. Inspired by this, we propose a new concept of α-conformable partial derivative. In the way of (1.4), α-conformable partial derivative is defined in as follows:

    Definition 2.1 [20] (α-conformable partial derivative) Let α(0,1] and s,t[0,). Suppose f(s,t) is a continuous function and partial derivable, the α-conformable partial derivative at a point s0, denoted by s(f)α(s,t), defined by

    s(f)α(s,t)=limε0f(seεsα,t)f(s,t)ε, (2.3)

    provided the limits exist, and call α-conformable partial derivable.

    Recently, Katugampola conformable partial derivative is defined in as follows:

    Definition 2.2 [20] (Katugampola conformable partial derivatives) Let α(0,1] and s,t[0,). Suppose f(s,t) and s(f)α(s,t) are continuous functions and partial derivable, the Katugampola conformable partial derivative, denoted by 2st(f)α2(s,t), defined by

    2st(f)α2(s,t)=limε0s(f)α(s,teεtα)s(f)α(s,t)ε, (2.4)

    provided the limits exist, and call Katugampola conformable partial derivable.

    Definition 2.3 [20] (α-conformable integral) Let α(0,1], 0a<b and 0c<d. A function f(x,y):[a,b]×[c,d]R is α-conformable integrable, if the integral

    badcf(x,y)dαxdαy:=badc(xy)α1f(x,y)dxdy (2.5)

    exists and is finite.

    Theorem 3.1 Let λ1 be a real number and α(0,1], and let p(s,t) be a nonnegative and continuous functions on [0,a]×[0,b]. Further, let x(s,t) be an absolutely continuous function and Katugampola partial derivable on [0,a]×[0,b], with x(s,0)=x(0,t)=x(0,0)=0 and x(a,b)=x(a,t)=x(s,b)=0. If p>1, 1p+1q=1 Then

    a0b0p(s,t)|x(s,t)|λdαsdαtp+qpq(1α2)λ1(a0b0Γabpqλα(s,t)p(s,t)dαsdαt)
    ×a0b0|2st(x)α2(s,t)|λdαsdαt, (3.1)

    where

    Γabpqλα(s,t)={(st)1/p[(as)(bt)]1/q}α(λ1).

    Proof From (2.4) and (2.5), we have

    x(s,t)=s0t02st(x)α2(s,t)dαsdαt.

    By using Hölder's inequality with indices λ and λ/(λ1), we have

    |x(s,t)|λ/p[(s0t0|2st(x)α2(s,t)|dαsdαt)λ]1/p
    (1α2(st)α)(λ1)/p(s0t0|2st(x)α2(s,t)|λdαsdαt)1/p. (3.2)

    Similarly, from

    x(s,t)=asbt2st(x)α2(s,t)dαsdαt,

    we obtain

    |x(s,t)|λ/q(1α2[(as)(bt)]α)(λ1)/q(asbt|qst(x)α2(s,t)|λdαsdαt)1/q. (3.3)

    Now a multiplication of (3.2) and (3.3), and by using the well-known Young inequality gives

    |x(s,t)|λ(1α2)λ1Γabpqλα(s,t)(s0t0|2st(x)α2(s,t)|λdαsdαt)1/p×(asbt|2st(x)α2(s,t)|λdαsdαt)1/q(1α2)λ1Γabpqλα(s,t)(1ps0t0|2st(x)α2(s,t)|λdαsdαt+1qasbt|2st(x)α2(s,t)|λdαsdαt)
    =p+qpq(1α2)λ1Γabpqλα(s,t)a0b0|2st(x)α2(s,t)|λdαsdαt, (3.4)

    where

    Γabpqλα(s,t)={(st)1/p[(as)(bt)]1/q}α(λ1).

    Multiplying the both sides of (3.4) by p(s,t) and α–conformable integrating both sides over t from 0 to b first and then integrating the resulting inequality over s from 0 to a, we obtain

    a0b0p(s,t)|x(s,t)|λdαsdαt
    p+qpq(1α2)λ1a0b0Γabpqλα(s,t)p(s,t)(a0b0|2st(x)α2(s,t)|λdαsdαt)dαsdαt
    =p+qpq(1α2)λ1(a0b0Γabpqλα(s,t)p(s,t)dαsdαt)a0b0|2st(x)α2(s,t)|λdαsdαt.

    This completes the proof.

    Remark 3.1 Let x(s,t) reduce to s(t) and with suitable modifications, (3.1) becomes the following result.

    a0p(t)|x(t)|λdαtp+qpq(1α2)λ1a0Γapqλα(t)p(t)dαta0|Dα(x)(t)|λdαt, (3.5)

    where Dα(x)(t) is Katugampola derivative (2.1) stated in the introduction, and

    Γapqλα(t)={t1/p(at)1/q}α(λ1).

    Putting p=q=2 and α=1 in (3.5), (3.5) becomes inequality (1.2) established by Agarwal and Pang [3] stated in the introduction.

    Taking for α=1, p=q=2 and p(s,t)=constant in (3.1), we have the following interesting result.

    a0b0|x(s,t)|λdsdt12(ab)λ[B(λ+12,λ+12)]2a0b0|2stx(s,t)|λdsdt,

    where B is the Beta function.

    Theorem 3.2 Let j=1,2 and λ1 be a real number, and let pj(s,t) be a nonnegative and continuous functions on [0,a]×[0,b]. Further, let xj(s,t) be an absolutely continuous function and Katugampola partial derivable on [0,a]×[0,b], with xj(s,0)=xj(0,t)=xj(0,0)=0 and xj(a,b)=xj(a,t)=xj(s,b)=0. Then for α(0,1]

    a0b0(p1(s,t)|x1(s,t)|λ+p2(s,t)|x2(s,t)|λ)dαsdαt
    12λ(1α2)λ1[(a0b0(st)α(λ1)p1(s,t)dαsdαt)a0b0|2st(x1)α2(s,t)|λdαsdαt
    +(a0b0(st)α(λ1)p2(s,t)dαsdαt)a0b0|2st(x2)α2(s,t)|λdαsdαt]. (3.6)

    Proof Because

    x1(s,t)=s0t02st(x1)α2(s,t)dαsdαt=asbt2st(x1)α2(s,t)dαsdαt.

    Hence

    |x1(s,t)|12a0b0|2st(x1)α2(s,t)|dαsdαt.

    By Hölder's inequality with indices λ and λ/(λ1), it follows that

    p1(s,t)|x1(s,t)|λ12λp1(s,t)(a0b0|2st(x1)α2(s,t)|dαsdαt)λ
    12λ(1α2)λ1(st)α(λ1)p1(s,t)a0b0|2st(x1)α2(s,t)|λdαsdαt, (3.7)

    Similarly

    p2(s,t)|x2(s,t)|λ12λ(1α2)λ1(st)α(λ1)p2(s,t)a0b0|2st(x2)α2(s,t)|λdαsdαt, (3.8)

    Taking the sum of (3.7) and (3.8) and α-integrating the resulting inequalities over t from 0 to b first and then over s from 0 to a, we obtain

    a0b0(p1(s,t)|x1(s,t)|λ+p2(s,t)|x2(s,t)|λ)dαsdαt
    12λ(1α2)λ1{a0b0((st)α(λ1)p1(s,t)a0b0|2st(x1)α2(s,t)|λdαsdαt)dαsdαt+a0b0((st)α(λ1)p2(s,t)a0b0|2st(x2)α2(s,t)|λdαsdαt)dαsdαt}=12λ(1α2)λ1[(a0b0(st)α(λ1)p1(s,t)dαsdαt)a0b0|2st(x1)α2(s,t)|λdαsdαt+(a0b0(st)α(λ1)p2(s,t)dαsdαt)a0b0|2st(x2)α2(s,t)|λdαsdαt].

    Remark 3.2 Taking for x1(s,t)=x2(s,t)=x(s,t) and p1(s,t)=p2(s,t)=p(s,t) in (3.6), (3.6) changes to the following inequality.

    a0b0p(s,t)|x(s,t)|λdαsdαt12λ(1α2)λ1
    ×(a0b0(st)α(λ1)p(s,t)dαsdαt)a0b0|2st(x)α2(s,t)|λdαsdαt. (3.9)

    Putting α=1 in (3.9), we have

    a0b0p(s,t)|x(s,t)|λdsdt12λ(a0b0(st)λ1p(s,t)dsdt)a0b0|2stx(s,t)|λdsdt. (3.10)

    Let x(s,t) reduce to s(t) and with suitable modifications, and λ=1, (2.10) becomes the following result.

    a0p(t)|x(t)|dt12(a0p(t)dt)a0|x(t)|dt. (3.11)

    This is just a new inequality established by Agarwal and Pang [4]. For λ=2 the inequality (3.11) has appear in the work of Traple [14], Pachpatte [13] proved it for λ=2m (m1 an integer).

    Remark 3.3 Let xj(s,t) reduce to xj(t) (j=1,2) and pj(s,t) reduce to pj(t) (j=1,2) with suitable modifications, (3.6) becomes the following interesting result.

    a0(p1(t)|x1(t)|λ+p2(t)|x2(t)|λ)dαt12λ(1α2)λ1[(a0tα(λ1)p1(t)dαt)a0|Dα(x1)(t)|λdαt
    +(a0tα(λ1)p2(t)dαt)a0|Dα(x2)(t)|λdαt]. (3.12)

    Putting λ=1 and α=1 in (3.12), we have the following interesting result.

    a0(p1(t)|x1(t)|+p2(t)|x2(t)|)dt12(a0p1(t)dta0|x1(t)|dt+a0p2(t)dta0|x2(t)|dt).

    Finally, we give an example to verify the effectiveness of the new inequalities. Estimate the following double integrals:

    1010[st(s1)(t1)]λdsdt,

    where λ1.

    Let x1(s,t)=x2(s,t)=x(s,t)=st(s1)(t1), p1(s,t)=p2(s,t)=p(s,t)=(st)1α, a=b=1 and 0<α1, and by using Theorem 3.2, we obtain

    1010[st(s1)(t1)]λdsdt
    =1010p(s,t)|x(s,t)|λdαsdαt12λ(1α2)λ1(1010(st)α(λ1)p(s,t)dαsdαt)1010|2st(x)α2(s,t)|λdαsdαt=12λ(1α2)λ1(1α(λ1)+1)21010[(2s1)(2t1)]λ(st)α1dsdt=12λ(1α2)λ1(1α(λ1)+1)2(12α111tλ1(t+1)1αdt)212λ(1α2)λ1(1α(λ1)+1)2(12α12αα)2=22λα2λ(α(λ1)+1)2.

    We have introduced a general version of Opial-Wirtinger's type integral inequality for the Katugampola partial derivatives. The established results are generalization of some existing Opial type integral inequalities in the previous published studies. For further investigations we propose to consider the Opial-Wirtinger's type inequalities for other partial derivatives.

    I would like to thank that research is supported by National Natural Science Foundation of China(11471334, 10971205).

    The author declares no conflicts of interest.



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