Markov chain models of cancer metastasis

We describe the use of Markov chain models for the purpose of quantitative forecasting of metastatic cancer progression. Each site (node) in the Markov network (directed graph) is an organ site where a secondary tumor could develop with some probability. The Markov matrix is an N x N matrix where each entry represents a transition probability of the disease progressing from one site to another during the course of the disease. The initial state-vector has a 1 at the position corresponding to the primary tumor, and 0s elsewhere (no initial metastases). The spread of the disease to other sites (metastases) is modeled as a directed random walk on the Markov network, moving from site to site with the estimated transition probabilities obtained from longitudinal data. The stochastic model produces probabilistic predictions of the likelihood of each metastatic pathway and corresponding time sequences obtained from computer Monte Carlo simulations. The main challenge is to empirically estimate the N^2 transition probabilities in the Markov matrix using appropriate longitudinal data.