Modeling an Immuno-Oncology Digital Twin Use Case for Osteogenic Sarcoma

Osteogenic Sarcoma occurs in the mandible and maxilla progressing from swelling and dysesthesia to tooth mobility. PD-1 is expressed on osteosarcoma tumor infiltrating cells. Here we have developed an educational simulation model with architecture in Python that uses object-oriented programming in a discrete-time simulation where each step advances the next using a state-machine style classifier. The intuitive output showed cytokine levels that increased with growth associated with increased numbers of NK, CD4 T cells, and CD8 T cells 2-fold. CD8T cells were the most abundant. The digital twin showed a 2- fold reduction in tumor cell number after PD-1 addition and 4-fold reduction after PD-1 and CTLA-4 combined therapy. The conserved cancer pathways are considered for validation in unique model organisms. The AI-driven digital twin ran in real time, showed the expansion of tumor growth in real-time, and reduced tumor cell capture with combined therapy indicating a functional digital twin model for Immuno-Oncology and Precision Medicine.