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| Format: | Recurso digital |
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Zenodo
2025
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| Online Access: | https://doi.org/10.5281/zenodo.17697466 |
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Table of Contents:
- <p><strong>ABSTRACT </strong><span>Current</span> <span>precision</span> oncology protocols suffer <span>from</span> a fundamental "longitudinal blindness": baseline genomic data becomes obsolete <span>as</span> the tumor evolves under therapeutic pressure, yet serial tissue biopsy remains logistically unscalable. This "Sampling Gap" forces clinicians <span>to</span> rely <span>on</span> volumetric (RECIST) criteria, which <span>are</span> lagging indicators <span>of</span> biological resistance.</p> <p>This <strong>Unified Surrogate Model</strong> proposes a theoretical framework <span>for</span> Integrated Surrogate Monitoring (ISM). <span>By</span> replacing unavailable molecular data <span>with</span> available clinical surrogates, we <span>define</span> a <span>4</span><span>-</span>dimensional topological space <span>to</span> track tumor evolution <span>in</span> <span>real</span><span>-</span><span>time</span>: <span>1.</span> The Kinetic Dimension (Dk): Mitotic rate via ctDNA<span>/</span>VAF trajectory. <span>2.</span> The Metabolic Dimension (Dm): Hypoxia<span>/</span>Glycolysis via FDG<span>-</span>PET dissociation. <span>3.</span> The Systemic Dimension (Dh): Immune permissiveness via dNLR <span>and</span> host reactants. <span>4.</span> The Morphological Dimension (Dr): Tissue entropy <span>and</span> invasiveness via radiomic texture analysis.</p> <p>This framework introduces the concept <span>of</span><strong> "Shadow Logic"</strong>—triangulating the state <span>of</span> the tumor <span>from</span> these orthogonal axes <span>to</span> identify <span>specific</span> resistance mechanisms (e.g., The Hollow Response, The Angiogenic Switch) prior <span>to</span> radiographic progression.</p> <p><strong><span>Keywords:</span></strong></p> <p><span>Precision Oncology, Liquid Biopsy, Radiomics, ctDNA, Tumor Evolution, RECIST, Surrogate Markers, Theoretical Biology, Integrated Diagnostics.</span></p> <p>NOTES This <span>is</span> a theoretical framework - intended <span>to</span> establish a topology <span>for</span> multi<span>-</span>modal monitoring. It invites validation against serial tissue banks <span>to</span> <span>define</span> the <span>specific</span> threshold coefficients <span>for</span> "Invisible Progression."</p>