Received 2 May 2016; accepted 27 June 2016; published 30 June 2016

1. Introduction
1.1. Summary of the Paper
We continue the study of the cancer model from Larsen (2016) [1] . The model is


where

are birth rates and T denotes transpose. Here
is chemotherapy
and
is immune therapy. The parameters
,
,
,
. We have shown previously Larsen (2016) [1] , that there are affine vector fields on
, such that their time one map is T, when the eigenvalues of A have positive real part. This enables you to find a formula for the rate of change of cancer growth in
. The characteristic polynomial of A is
![]()
when
The discriminant of this polynomial is
![]()
The eigenvalues are
![]()
In section two we prove the Bistability Theorem for a mass action kinetic system of metastatic cancer
and primary cancer C. The model also has
growth factors and
growth inhibitors. We show that for some values of the parameters there are exactly two positive singular points
where
We prove that
is unstable and
is stable, when one of the rate constants is small.
For
we have: if the eigenvalue
of A has
then one can find an affine vector field, whose time one map is
. Similarly, when
and the eigenvalues
of the cha- racteristic polynomial of A are nonzero, then one can find an affine vector field on
, whose time one map is
. This enables us to find a formula for the rate of change of cancer growth in
This is the subject of Section 3.
The phase space of our model T is
. In section four we show, that when
,
,
,
orbits of the vector field associated to T will escape phase space for both
and
. We obtain a formula for the first escape time. There is a similar treatment for ![]()
1.2. The Litterature
uPAR (urokinase plasminogen activator receptor) is a cell surface protein, that is associated with invasion and metastasis of cancer cells. In Liu et al. (2014) [2] a cytoplasmic protein Sprouty1 (SPRY1) an inhibitor of the (Ras-mitogen activated protein kinase) MAPK pathway is shown to interact with uPAR and cause it to be degraded. Overexpression of SPRY1 in HCT116 or A549 xenograft in athymic nude mice, led to great suppression of tumor growth. SPRY1 is an inhibitor of the MAPK pathway. Several cancer cells have a low basal expression of SPRY1, e.g. breast, prostate and liver cancer. SPRY1 promotes the lysosomal mediated degradation of uPAR. SPRY1 overexpression results in a decreased expression of uPAR protein. This paper suggests that SPRY1 regulates cell adhesion through an uPAR dependant mechanism. SPRY1 inhibits proliferation via two distinct pathways: 1) SPRY1 is an intrinsic inhibitor of the Raf/MEK/ERK pathway; 2) SPRY1 promotes degradation of uPAR, which leads to inhibition of FAK and ERK activation.
According to Luo and Fu (2014), [3] EGFR (endoplasmic growth factor receptor) tyrosine kinase inhibitors (TKIs) are very efficient against tumors with EGFR activating mutations in the EGFR intracytoplasmic tyrosin kinase domain and cell apoptosis was the result. However some patients developed resistance and this reference aimed to elucidate molecular events involved in the resistance to EGFR-TKIs. The first EGFR-TKI s to be approved by the FDA (Food and Drug Administration, USA) for treatment of NSCLC (non small cell lung cancer) were gefitinib and erlotinib. The mode of action is known. These drugs bind to the ATP binding site of EGFR preventing autophosphorylation and then blocking downstream signalling cascades of pathways RAS/ RAF/MEK/ERK and PI3K/AKT with the results, proliferation inhibition, cell cycle progression delay and cell apoptosis.
There are several important monographs relevant to the present paper, see Adam & Bellomo (1997), [4] , Geha & Notarangelo (2012), [5] , Murphy (2012), [6] , Marks (2009), [7] , Molina (2011), [8] .
2. A mass Action Kinetic Model of Metastatic Cancer
The main result of this section is Theorem 1 below that proves the bistability of the mass action kinetic system (1) to (8). Consider then the mass action kinetic system from Larsen (2016), [9] , in the species
primary cancer cells, metastatic cancer cells, growth factor, growth inhibitor respectively.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
The complexes are
And this defines the rate constants
. With mass action kinetics the ODE s become
![]()
![]()
![]()
![]()
all
We shall now find the singular points of this vector field denoted
![]()
But first we state a theorem, we shall next prove. A positive (nonnegative) singular point ![]()
of f is a singular point of f, such that
Define
![]()
Theorem 1 Assume
When
there are exactly two positive singular points
![]()
where
is unstable. Given
such that
and,
then there exists
such that ![]()
is stable when ![]()
Consider a singular point
of f and linearize
![]()
Setting the last coordinate of f equal to zero gives
![]()
when
Now insert this into the first and second coordinates of f to get
(9)
and
(10)
When
we get from (9)
![]()
and from (10) we get
![]()
This means that B simplifies to
![]()
Let
denote the matrix you obtain by deleting row three and column three in B. Then
![]()
Also
![]()
The characteristic polynomial of
is denoted
![]()
Finally
![]()
In Larsen (2016) [9] , we found two cubic polynomials
such that
![]()
whenever
is a nonnegative singular point of f. We shall need the following lemma.
Lemma 1 Assume
Then
![]()
where
![]()
![]()
![]()
Proof. The coefficient to
is according to Larsen (2016), [9]
![]()
and
The coefficient to
is according to Larsen (2016), [9]
![]()
Everything cancels out and leaves a zero. The coefficient to
is according to Larsen (2016), [9]
![]()
Square
and multiply
to get
![]()
Everything cancels out except
![]()
The coefficient to
is according to Larsen (2016), [9]
![]()
Multiply
![]()
Everything cancels out except
![]()
Finally the constant term is
![]()
The lemma follows.
Theorem 2 Assume
When
there are exactly two positive singular points of f
![]()
where
![]()
Proof. We have
![]()
where
![]()
![]()
![]()
and
![]()
![]()
![]()
due to symmetry of
When
P and
have two positive roots
![]()
in P and
![]()
in
, see (15) and (16) below. We are going to verify that
(11)
are singular points of f and that
(12)
are not singular points of f. Here
![]()
and
![]()
Also
(13)
(14)
We have
(15)
and logically equivalent
(16)
where
To see (15) compute
![]()
So
![]()
and from this the formula follows. And (16) is a similar computation.
We shall insert (15), (16) in the first coordinate of f, multiplied with ![]()
![]()
Now abbreviate
and find
![]()
Multiply with
to get
![]()
But this amounts to
![]()
and this vanishes due to the formula for roots of quadratic polynomials. That the second coordinate vanishes is logically equivalent. So (11) are singular points of f.
We shall now argue, that
![]()
is not a singular point of f. To this end define
![]()
Insert the formulas (15), (16) for
in the first coordinate of f multiplied with
to get
![]()
Multiply with
to find
(17)
(18)
But (17) is zero by the above and (18) is nonzero. So
is not a singular point. That
is not a singular of f is logically equivalent. The theorem follows.
In the remainder of the proof of Theorem 1, we assume, that
![]()
We shall now verify that
is unstable. We shall show that ![]()
But we have
![]()
Simply insert (15) and (16) in the numerator
![]()
Now we use that
![]()
so
![]()
is equivalent to
![]()
The right hand side here is negative and the left hand side is positive. Thus
has a positive eigenvalue. So
is unstable.
We shall now show that
is stable, when
is small. We shall use the Routh Hurwitz criterion. So we start by showing, that
But similarly to the above
![]()
But this amounts to
![]()
which is equivalent to
![]()
and this again is equivalent to
![]()
and from this it follows that
We have the following formula for ![]()
![]()
And a formula for ![]()
![]()
Define
![]()
so that
![]()
Now introduce these two formulas in the formulas for ![]()
![]()
![]()
Notice that
for small
Also
![]()
is negative for small
The Routh Hurwitz criterion says in our framework, that ![]()
is equivalent to stability of
But
is equivalent to
because our assumptions imply
So
is equivalent to
![]()
This equation holds for small
. So
is stable for small
. This follows by writing
![]()
where
and h is smooth. This is the standard trick from singularity theory. Then
![]()
And from this it follows that
is stable for small
. To be precise, given
such that
and,
then there exists
such that
is stable when
Theorem 2 follows.
Consider the mass action kinetic system in the species
cancer cells, growth factor, growth inhibitor and a protein, respectively.
(19)
(20)
(21)
(22)
(23)
(24)
(25)
The complexes are ![]()
And this defines the rate constants
. With mass action kinetics the ODE s become
![]()
![]()
![]()
![]()
see Horn and Jackson (1972), [10] . Notice that (24), (25) are the Brusselator, which is known to have oscillating solutions for some values of the parameters, see Sarmah et al. (2015), [11] . Subtracting
on both sides of (25) gives the reaction
Let
With these parameter values and initial conditions
the system oscillates, see Figure 1.
3. Eigenvalues with Negative Real Part
In this section
in the discrete model T of the introduction. The purpose of this section is to find a formula for the rate of change of cancer growth
![]()
Figure 1. The oscillating mass action kinetic system. I have plotted P versus C.
![]()
on the hyperplane
Here
is an integral curve of the vector field Y, defined below. There are four cases to consider. First assume, that
Let
We shall assume that
Define
![]()
and compute, when ![]()
![]()
If
has negative real part we might be able to find an affine vector field whose time one map is
. Notice that
![]()
By Larsen (2016), [1] ,
![]()
Then
![]()
Define the vector field
(26)
and let
![]()
where
The flow of X is
(27)
(28)
where
Also
![]()
If
![]()
![]()
then
![]()
Assume that
Then we can let
![]()
But this means that
![]()
because we have
![]()
So we get
![]()
i.e.
Consider first the immune therapy model
![]()
So assuming ![]()
![]()
We want to have
![]()
and
![]()
such that
![]()
Here
denotes the time one map of X and
Define
![]()
Then
![]()
Thus
![]()
Now
![]()
Define
![]()
Let
denote the first row in U. Compute letting
![]()
![]()
where
is an integral curve of Y through
And, because
this is equal to
![]()
Now suppose
and
distinct and define
![]()
Then
![]()
when
because the columns of D are eigenvectors of A corresponding to eigenvalues
respectively. Compute, when
the inverse
![]()
Then
![]()
Define the vector field
(29)
X has flow
(30)
and the time one map is
![]()
and we want this to be
![]()
Then define the vector field
![]()
This vector field has time one map
![]()
Then arguing as before
![]()
and
![]()
We can now find
![]()
Next consider the chemo therapy model
![]()
and initially, that
Define the vector field X by (26). It has flow (27), (28). Define the vector field
![]()
We want this vector field to have time one map
![]()
Then we find
![]()
Now compute arguing as above
![]()
Finally we can find
![]()
and this becomes
![]()
Now consider the chemo therapy model, when
and
distinct. Define the vector field X by (29). It has flow (30). Here
![]()
The second coordinate here should be equal to
![]()
while the third coordinate should be equal to
![]()
in order that the time one map of
is
. Now we can find
![]()
and this is simplified to
![]()
Remark 1 When
then
that is
So
by the above you can find an affine vector field whose time one map is
. Similarly when
then
and
So by the above, you have a formula for
on ![]()
4. Escaping Phase Space
In this section
The phase space of our model T of the introduction is
. When
integral curves of B from theorem 1 in Larsen (2016), [1] , starting in
will always escape phase space for both
and
Here
![]()
and
where
![]()
U as in section 3. This vector field, B, has time one map T, see Larsen (2016), [1] , or argue as in Section 3.
The purpose of this section is to prove, that there exists a first escape time
, i.e. the existence of a smallest
, such that
![]()
When
we prove, that either
![]()
or there exists a smallest
such that
![]()
Proposition 3 Suppose
Given
then there exists
such that
![]()
![]()
Proof. We have the following formula for the flow of B
![]()
Here
![]()
![]()
and
![]()
Define
![]()
![]()
Since
we can define
by
![]()
It follows that we have the following formula
![]()
Since
the proposition follows.
Remark 2 By the proof we have
![]()
implies
Here
. Let
denote the smallest positive solution to ![]()
When
we have the following proposition using the definitions
![]()
![]()
These formulas are explained in the proof of Proposition 4.
Let
where
![]()
D as in section 3. B has time one map T, see Larsen (2016), [1] , or argue as in section three.
Proposition 4 Suppose
Let
be given. (i) If
then there exists a unique
such that
![]()
If
then
![]()
for all
.
(ii) If
then there exists a unique
such that
![]()
If
then
![]()
for all
.
Proof. First of all the flow of F is
![]()
![]()
We have the following formula
![]()
where
is the first row of D. From this equation, (i) follows. For (ii) write
![]()
From this formula, (ii) follows.
Remark 3 In case (i) of the proposition, if
we have
![]()
implies
![]()
In case (ii) of the proposition, if
we have
![]()
implies
![]()
We shall now derive a formula for the first escape time
To start with, assume that
Notice that
![]()
and
![]()
where
![]()
![]()
![]()
i.e.
![]()
Compute
![]()
![]()
where
![]()
If
let
If
define
by
![]()
Then we have the following formulas
(31)
(32)
Assume that
Then there exists
such that
![]()
for
If there exists
such that
![]()
we claim that there are atmost finitely many such solutions and hence that there exists a smallest
such that
![]()
Assume for contradiction, that there are infinitely many solutions to
![]()
By (31) there are exactly
solutions to
![]()
Since there are infinitely many solutions to
there exist
![]()
in
such that
![]()
By the mean value theorem, there exists
such that
![]()
Hence
![]()
A contradiction and there are only finitely many solutions to
If there exists a
such that
let
denote the smallest such number, and otherwise let ![]()
If
then
![]()
Since
then
Define
by
(33)
so
![]()
By
denote the smallest positive solution to
Suppose
and
if
let
otherwise write (33). If
![]()
let
otherwise let
![]()
so that
![]()
By
denote the smallest positive
. Here
![]()
Suppose
If
let
otherwise write (33). Then there exists
such that
By
denote the smallest positive solution to
arguing as above.
If
for all
let
otherwise denote by
the smallest positive solution to
Now define the first escape time
by
![]()
We shall now find the first escape time when
Then we have
![]()
and
![]()
where
![]()
![]()
![]()
i.e.
![]()
Assume in the notation of Proposition 4, that
and let
![]()
If
let
Now compute
![]()
and
![]()
There are atmost two solutions to
If there exists
such that
let
denote the smallest such solution, otherwise let
If there exists
such that
let
denote the smallest such solution, otherwise let
Now define the first escape time, when ![]()
![]()
5. Summary and Discussion
In this paper we proved that the model of primary and metastatic cancer in Section 2 is bistable, in the sense, that there are exactly two positive singular points. One of them is unstable, and when one of the rate constants is small the other is stable. Then we found formulas for the rate of change of cancer growth for the model T of the introduction, when for
the eigenvalues
are nonzero and for
when
In section four we proved that there is a first escape time for the flow of the affine vector field associated to T when
A similar result when
was also treated.
It would be interesting to figure out what happens if the polynomials
of section 2 are cubic polynomials and not quadratic as in Theorem 1.
How do cancer cells coordinate glycolysis and biosynthesis. They do that with the aid of an enzyme called Phosphoglycerate Mutase 1. In the reference [12] , the authors suggest a dynamical system for their findings in a figure at the end of the paper. In the reference [13] , A. K. Laird showed that solid tumors do not grow exponentially, but rather like a Gompertz function. The publications of the author are concerned with semi Riemannian dynamical systems, e.g. Lorentzian Geodesic Flows, see [14] and electrical network theory of countable graphs, see [15] , [16] .