# KiKa grant for mathematician: how statistics helps fight bone cancer

Using mathematics to help children with bone cancer. It sounds a little strange, but for statistician Marta Fiocco, it's just her job. She gets a substantial grant from KiKa for it. With that money, she is going to study the effect of chemotherapy adjustments.

Chemotherapy, especially for young patients, is a tough treatment that causes considerable damage. As a doctor, you don't want to give too much of it, but enough to fight the cancer cells. That's a delicate trade-off. How do you find that balance?

According to Marta Fiocco, professor of Applied Mathematics, statistics can help with that. With the PACT-ES research project, Fiocco, together with her mathematical and clinical colleagues, are trying to map the effects of adjustments in chemotherapy. They are doing this for patients with Ewing sarcoma, an aggressive form of bone cancer. Ultimately, they want to predict the effect of a given dose on treatment and side effects.

‘We don't have a crystal ball to look into the future, but I do hope we can develop a method to study this further. It would be very nice if we could indicate in which situations the dosage of chemotherapy could be lowered.’

## Using existing data in a different way

To study this, you need data. Fiocco and her colleagues will use data from a scientific study on the treatment of Ewing sarcoma. ‘Such a study compares the effect of two different treatments, but in reality there are all kinds of reasons why doctors have to deviate from the protocols. If there are too many side effects, the doctor can decide to delay treatment or reduce the dose.’ In a scientific study, all that kind of information must be recorded. Fortunately, because without this information, Fiocco would not have been able to get started.

## Project PACT-ES receives €546,000 from KiKa

Marta Fiocco is project leader of PACT-ES: Personalised Approach to Chemotherapy Treatment for Ewing's Sarcoma. This project aims to investigate the effect of modifications in chemotherapy with a dynamic prediction model. KiKa awarded 546,000 euros in funding. The project also involves prof.dr. Hans Merks of the Princess Máxima Center as clinical project leader, and dr. Marta Spreafico of the Mathematical Institute and prof. Bernadette Brennan of the Royal Manchester Children's Hospital as co-investigators, among others. The data the researchers are using is from the Euro Ewing 2012 International Multicentre Trial, of which Brennan is principal investigator.

## No new drugs, but new treatments

In recent years, fewer new cancer drugs have come to market, but there has been more interest in new treatments with existing drugs. This is precisely that balance between treating the tumor effectively and doing as little damage as possible, which is also the focus of the PACT-ES project. Here, data is the starting point, and for this, you need people who understand and analyze that data. Fiocco and her research team can do that.

Ultimately, Fiocco and her colleagues want to develop a general tool that can also be used for other types of cancer. With that tool, they can better analyse what happens during treatment. ‘The project is very nice for me as a mathematician, but most of all I hope it will support physicians in their decision on how to use medication. They can take that knowledge and make a difference for the children.’

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