Analysis of a mathematical model of the eect of inhibitors on
the growth of tumors
Shangbin Cui
a,b, Avner Friedman
c,* aDepartment of Mathematics, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
b
Institute for Mathematics and its Applications, University of Minnesota, Minneapolis, MN 55455, USA
c
Department of Mathematics, University of Minnesota, 206 Church Street, SE, Minneapolis, MN 55455-0488, USA
Received 21 August 1998; received in revised form 23 September 1999; accepted 18 November 1999
Abstract
In this paper, we study a model of tumor growth in the presence of inhibitors. The tumor is assumed to be spherically symmetric and its boundary is an unknown function rR t. Within the tumor the con-centration of nutrient and the concon-centration of inhibitor (drug) satisfy a system of reaction±diusion equations. The important parameters areK0(which depends on the tumor's parameters when no inhibitors
are present), c which depends only on the speci®c properties of the inhibitor, and bwhich is the (nor-malized) external concentration of the inhibitor. In this paper, we give precise conditions under which there exist one dormant tumor, two dormant tumors, or none. We then prove that in the ®rst case, the dormant tumor is globally asymptotically stable, and in the second case, if the radii of the dormant tumors are denoted byRÿ
s;Rs withRÿs <Rs, then the smaller one is asymptotically stable, so that limt!1R t Rÿs,
provided the initial radiusR0is smaller thanR
s; if howeverR0>Rs then the initial tumor in general grows
unboundedly in time. The above analysis suggests an eective strategy for treatment of tumors. Ó 2000
Elsevier Science Inc. All rights reserved.
Keywords:Tumors; Inhibitors; Parabolic equations; Free boundary problems
1. The model
In this paper, we study a model recently proposed by Byrne and Chaplain [1] for the growth of tumor in the presence of inhibitors. The tumors consists of life cells (non-necrotic tumor) and receives blood supply through a developed network of capillary vessels (vascularized tumor). The
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E-mail address:friedman@math.umn.edu (A. Friedman).
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blood supply provides the tumor with nutrients as well as inhibitors. Inhibitors may also diuse into the tumor from neighboring tissues. The inhibitors may develop from the immune system of healthy cells, as well as from drugs administered for therapy.
The paper develops mathematical techniques for rigorous analysis of transient and stationary solutions to such models. In the particular model under study they allow us to con®rm, but also signi®cantly extend, the results obtained in [1] through numerical studies.
As in other models developed over the last 30 years (see, e.g., [2±6] and the references cited therein), Byrne and Chaplain represent the tumor's evolution in the form of a free-boundary
problem whereby its growth is determined by the levels of diusing nutrient and inhibitor
con-centrations. In contrast with previous ones, however, their model departs from in vitro growth scenarios by taking into account the possible blood±tissue nutrient transfer that occurs in vivo through angiogenesis as described and modelled in [7,8, Ch. 5]. (Angiogenesis is a process by which tumors induce blood vessels to sprout capillary tips which migrate toward, and penetrate into, the tumor, thus providing it with circulating blood supply.) Further, the model includes a well-motivated cell-loss mechanism, apoptosis, which implies the existence ofdormant(stationary) non-necrotic tumor states.
Following [1], we shall assume the tumor to be spherically symmetric and to occupy a region
fr<R tg rjxj; x x1;x2;x3
at each time t; the boundary of the tumor is given by rR t, an unknown function oft. Then, after non-dimensionalization, the (dimensionless) nutrient concentration r^ r;t will satisfy a reaction±diusion equation of the form
cor^
ot
1
r2
o
or r
2or^
or !
C1 rBÿr^ ÿk0r^ÿc1b^ if r<R t; t>0; 1:1
whereb^is the (dimensionless) inhibitor concentration. Here the constantsrB and C1 denote the
(dimensionless) nutrient concentration in the vasculature and the rate of nutrient-in-blood±tissue transfer per units length, respectively. Thus C1 rBÿr accounts for the transfer of nutrient by
means of the vasculature, whose presence stems from angiogenesis. The termk0r^is the nutrient
consumption rate,c1b^is the inhibitor consumption rate, andcTdiffusion=Tgrowth is the ratio of the nutrient diusion time scale to the tumor growth (e.g., tumor doubling) time scale. Note that, typically, Tdiffusion1 min (see [8, pp. 194±195]) while Tgrowth 1 day, so that c1.
The (dimensionless) inhibitor concentrationb^satis®es a similar reaction±diusion equation [1]
c2o
^ b ot
D2 r2
o
or r
2ob^
or !
C2 bBÿb^ ÿc2b^ if r<R t; t>0; 1:2
where the constantbBdenotes the (dimensionless) inhibitor concentration in the vasculature,C2is
inhibitor-in-blood±tissue transfer per unit length, andc2b^is the inhibitor consumption rate. Here
D2 is the (dimensionless) diusion coecient of the inhibitor concentration, and c2=D2 is the quotient of the inhibitor diusion time scale to the tumor growth time scale; typicallyD2 1 so that c2 1. Actually C2 0 in [1]; however if the inhibitor is partially fed through the
vascu-lature, then C2 >0.
1
r2
o
orr
2 o
or
is meant to denote the radial part of the Laplace operator (in 3 dimensions), and therefore one must include the conditions
or^
or 0;t 0; ob^
or 0;t 0: 1:3
Assuming that the mass density of cells is constant, the principle of conservation of mass coincides with the principle of conservation of volume. A reasonable simpli®ed approach to this principle, developed in [2], gives the relation
d dt
4 3pR
3
t
Z 2p
0
Z p
0
Z R t
0
S r^;b^r2sinhdrdhdu; 1:4
where S r^;b^ denotes the cell proliferation rate within the tumor. For simplicity we restrict ourselves to the inhibitor-free proliferation rate [1]
S r l r^ÿr~~; 1:5
whereland~~rare positive constants. This means that the cell birth-rate islr^while the death-rate (apoptosis) is given bylr~~. Finally, the external nutrient concentration is assumed to be a constant
rand the external inhibitor concentration is assumed to be a constant b, so that
^
rr; b^b on rR t: 1:6
The case where inhibitors are absent was recently studied by Friedman and Reitich [9] under the assumption that
r>r~~> C1rB
C1k0
: 1:7
Extending the results obtained in [1] by perturbative and numerical studies, they proved by rig-orous mathematical analysis that there exists a unique stationary solutionR t Rs and that this solution is asymptotically stable for the time-dependent problem, providedcis suciently small; the asymptotic stability was only formally proved in [1] and only so in the limit casec0.
The present work includes the presence of inhibitor, and our interest is to study the eect of the inhibitor on the tumor's growth. We shall not make the assumption (1.7), but for simplicity we shall require that
b> C2bB
C2c2
1:8
or, equivalently, that
C2 bBÿb<c2b: 1:9
Remark 1.1.The methods presented in this paper can be extended to the case where (1.8) is not satis®ed, but the results will be dierent.
It will be convenient to simplify the system (1.1)±(1.5) by introducing the following notation:
c0 c2
The speci®c value ofl(in (1.5)) will not aect the results of this paper. In order to slightly simplify the calculations, we shall take l3. Then, introducing the normalized nutrient and inhibitor concentrations,r and b, by
rr^ÿ C1rB
the system (1.1)±(1.6) reduces to
cor
Note that the assumption (1.8) means that
b>0; 1:17
as mentioned above, we can actually allow bto be any real number though we shall not do so in this paper.
Finally we have initial conditions
r r;0 u0 r; b r;0 w0 r if 06r6R0; ou0
We may view k and c as the consumption±transfer coecients of the nutrient and inhibitor, respectively, andbas the normalized external concentration of the inhibitor.
In this paper, we shall prove that there exists a unique solution to the system (1.12)±(1.18) for all t>0. However our main interest is to establish the existence of stationary solutions and to study their asymptotic stability with respect to the non-stationary solution. Our results will de-pend on just four constants
K0
1 3
~ r
r; K1 b
cÿkr; /
c k r
; r0 ÿ
b
k: 1:19
We shall always assume that
min r;r06u0 r6max r;0;
06w0 r6b for 06r6R0: 1:20
For simplicity we always assume that
c6k; 1:21
so thatK1 is well-de®ned, andK1 60; the case ck is brie¯y considered in Remark 6.3.
We ®rst show that ifr~<min r;r0, then R t ! 1ast! 1, whereas ifr~>max r;0, then R t !0 as t! 1. The function
f g 1ÿK1p g K1p /g p g
g cothg2gÿ1
will play a fundamental role in studying all the remaining cases. We shall prove the following results:
A1 If 0<K0 <13 then there exists a unique stationary solution rs;bs;Rs which is asymp-totically stable if rP0 and unstable if r<0, with respect to the time-dependent solutions of (1.12)±(1.18).
A2 Ifÿ 1= /16 /ÿ1K16/, and K062 0;13then no stationary solutions exist.
A3If /ÿ1K1>/thenK0ming>0f g<0, and whenK0P13; or K06K0, no stationary
solutions exist. However whenK0 <K0 <0 then there exist two stationary solutions, rÿs;b
ÿ
s;Rÿs and rs;bs;Rs, withRÿs <Rs;Rÿs is asymptotically stable whereasRs is unstable.
A4 If /ÿ1K1 <ÿ 1= /1 then K0 maxg>0f g>0, when K060, or K0PK0 , no
stationary solution exist. However, when1
3<K0 <K
0 then there exist two stationary solutions as
in case A3, and againRÿs is asymptotically stable whereas Rs is unstable.
The above results are proved under the assumption thatcandc0are suciently small. We shall also prove that when no stationary solutions exist then there are initial data for which
lim
t!1R t 1:
The mathematical results of this paper have implications for the treatment of tumor. Consider for example the case wherer~<0<r, so that with no inhibitors the tumor will grow unboundedly. Then, by administering inhibitor (drug) with suciently large external (normalized) concentration
provided the initial size of the tumor is below a certain radius R
s b
, whereas if bis further increased so that it becomes larger thanbthen the tumor will de®nitely be contained and it will evolve into a dormant one with radiusRÿ
s, more details will be given in Section 7.
2. Global existence and uniqueness
Theorem 2.1. The system (1.12)±(1.18) has a unique solution r;b;R for allt>0 and
0<b r;t<b for06r<R t; t>0; 2:1
min r;r0<r r;t<max r;0 for06r<R tt>0; 2:2
R0expftmin r;r0 ÿr~g6R t6R0expftmax r;0 ÿr~g for tP0; 2:3
min r;r0 ÿr~6
_
R t
R t 6max r;0 ÿr~ for tP0: 2:4
Proof.Local existence and uniqueness can be proved as in the case of the Stefan problem [1]. If we can prove the a priori bounds (2.3) and (2.4), then the solution can be continued for allt>0. On the other hand (2.4), and consequently also (2.3), follows from (2.2) and (1.16). Thus it remains to prove (2.2) and (2.1). These assertions follow by the maximum principle. Indeed, (2.1) is rather immediate; as for (2.2), by comparison we have that r1 r;t6r r;t6r2 r;t, where
cor1
ot
1
r2
o
or r
2or1
or
ÿkr1ÿb; 2:5
cor2
ot
1
r2
o
or r
2or2
or
ÿcr2 2:6
for 0<r <R t; t>0 and
r1 R t;t r2 R t;t r if t>0;
r1 r;0 min r;r0; r2 r;0 max r;0 if 06r<R 0:
By comparison
r2 r;t6 max r;0
and also (using the relationkr0b0)
r1 r;tP min r;r0
so that (2.2) holds.
Corollary 2.2.
(i) Ifmax r;0<r~ thenlimt!1R t 0;
(ii)Ifmin r;r0>r~ thenlimt!1R t 1.
Therefore in studying the asymptotic behavior of R t we shall concentrate just on the case where
min r;r06r~6max r;0: 2:7
Henceforth it will be assumed that (2.7) is satis®ed.
3. Steady-state solutions
The steady-state solution, if existing, is determined by the system
1
Substituting (3.6) and (3.7) into (3.5) we obtain
1ÿK1r
It will be convenient to introduce the variable
gs pkRs; 3:9
and the functions
p g gcothgÿ1
g2 ; 3:10
f g 1ÿK1p g K1p /g: 3:11
Dividing (3.8) by rRs, we obtain the relation
f gs K0: 3:12
Thus we have proved:
Lemma 3.1. The system(3.1)±(3.5)has a solution if and only if Eq.(3.12)has a positive solutiongs, and, in that case, the solution Rs;rs;bs is given by (3.9), (3.7)and(3.6).
The remaining of this section is devoted to determining how many solutions Eq. (3.12) admits. We ®rst need two lemmas.
Lemma 3.2.
(i) p0 g<0for allg>0;
(ii) limg!0p g 13; limg!1p g 0; limg!1gp g 1;
(iii) 0<p g<1
3; 0<gp g<1for all g>0.
The ®rst part is proved in [9], and the other parts are rather immediate.
Lemma 3.3. The function
k g gp
00 g
p0 g
is strictly monotone decreasing and in fact, k0 g<0 for allg>0.
Proof.By direct computation
k g 2 sinh
3
gÿg3coshg
g2gcoshgsinhgÿ2 sinh2g
sinhgÿ2 and
k0 g ÿ 2g g
g2gcoshgsinhgÿ2 sinh2g2sinh2g;
where
Thus it remains to show thatg g>0 for all g>0.
one can easily verify that, for gP2,
g geÿ6gP 1
Applying the lower bounds to the ®ve positive terms in g g=g5 and the upper bounds to the
®rst two negative terms ing g, we obtain after some calculations,
g g
where` g is a polynomial of degree 48 with positive coecients, so that
` g< ` 2:25 1:8364410ÿ5 if 0<g<2:25:
For suchgwe then get, by computing the coecients of each power ofgin the above expression,
and the expression in parenthesis is>ÿ3:4985 if 0<g<2:25. Hence
g g g15 10
5P75:2499
30:0999ÿ3:4985g2g2 >0
if 0<g<2:25 since the expression in parenthesis is positive.
Corollary 3.4.
If/>1 0</<1 then
d dg
p0 /g
p0 g <0 >0 for all g>0: 3:13
Proof.Clearly
d dg
p0 /g p0 g
p0 g /p00 /g ÿp0 /g p00 g
p0 g2
/gp00 /g p0 /g
ÿgp
00 g
p0 g
p0 /g
gp0 g:
Since the last factor is positive by Lemma 3.2, the assertion follows from Lemma 3.3.
In the next theorem we analyze the behavior of the function f gde®ned in (3.11), note that
f 0 1
3; glim!1f g 0: 3:14
Theorem 3.5. (i) Ifÿ 1
/1< /ÿ1K16/then
f0 g<0 for all g>0: 3:15
(ii)If /ÿ1K1 >/ then there is a uniqueg0 such that
f0 g<0 for 0<g<g0; f0 g>0 forg>g0 3:16
and, by (3.14),
K0f g0 min
g>0f g<0:
(iii) If /ÿ1K1<ÿ/11 then there exists a uniqueg0>0, such that
f0 g>0 for 0<g<g0; f0 g<0 forg>g0 3:17
and, by (3.14),
K0 f g0 max
g>0 f g>
1 3:
Proof.Note that
f0 g p0 g 1
ÿK1 /K1 p0 /g
p0 g
Also, by simple calculation,
lim
g!0 p0 /g
p0 g /; glim!1 p0 /g
p0 g
1
/2: 3:19
Consider ®rst the case 06 /ÿ1K16/. Then K1P0 (respectively, K1 <0) implies /P1
(respectively, /<1), so that, by Corollary 3.4, p0 /g=p0 g is strictly monotone decreasing
(re-spectively, increasing). Consequently, by (3.19),
p0 /g
p0 g >
1
/2 respectively;
< 1
/2
so that the expression in brackets in (3.18) is> 1ÿK1 /K1=/2. Sincep0 g<0, we get from
(3.18),
f0 g<p0 g 1
ÿK1
/K1
/2
p0 g/ÿ /ÿ1K1
/ 60
and (3.15) follows. The remaining case of (i), namely,ÿ1= /16 /ÿ1K1 <0, can be proved
similarly.
To prove (ii), note that /ÿ1K1 >/ implies that
1
/2 < K1ÿ1
/K1
</ if K1 >0 () />1; 3:20
/<K1ÿ1
/K1
< 1
/2 if K1 <0 () /<1: 3:21
From Lemma 3.2(i) and (3.18)±(3.20) we see that ifK1>0 then
f0 g p0 g 1ÿK1 K1/2<0 if g is near 0;
f0 g p0 g 1ÿK1
K1
/>0 if g is near 1:
Similarly if K1<0 then (using (3.21))
f0 g<0 if g is near 0;
f0 g>0 if g is near 1:
Hence in both cases there exists a pointg0such thatf0 g0 0. Sincep0 gnever vanishes whereas the expression in brackets in (3.18) has everywhere negative derivative if />1 and everywhere positive derivative if /<1 (by Corollary 3.4), we deduce that f0 g has a unique zero and (ii) readily follows. Finally, (iii) is established by the same argument as (ii).
From Lemma 3.1 and Theorem 3.5 we obtain the following results concerning the existence of stationary solution of (3.1)±(3.5):
Theorem 3.6.
(i)Ifÿ1= /1< /ÿ1K16/, then for0<K0 <13there exists a unique stationary solution
(ii)If /ÿ1K1>/ then for06K0 <13 there exists a unique stationary solution (rs;bs;Rs; for K0 <K0<0 K0ming>0f g<0 there are two stationary solutions rÿs;bÿs ;Rÿs and r
s;b
s;Rs with Rÿs <Rs; for K0K0 the two solutions coincide, and for K062 K0; 1 3 there
are no stationary solutions.
(iii) If /ÿ1K1 <ÿ1= /1 then for 0<K0613 there exists a unique stationary solution
rs;bs;Rs; for 13<K0<K0 K0 maxg>0f g>13) there are two stationary solutions
rÿ
s;b
ÿ
s;Rÿs and rs;b
s;Rswith Rÿs <Rs; forK0 K0 the two solutions coincide, and forK0
62 0;K0 there are no stationary solutions.
We shall be interested in the asymptotic behavior of the solution of (1.12)±(1.18). In order to gain some insight about what to expect, we brie¯y consider the limiting case where cc0 0. Then, for each t>0,
b r;t
bR t
sinh pcR
t
sinh pcr
r ; 3:22
Fig. 1. 06 /ÿ1K16/.
r r;t 1ÿK1
rR t
sinh k p
R t
sinh k p
r
r K1
rR t
sinh pcR
t
sinh pcr
r : 3:23
Substituting the last expression into (1.16) and setting g t pkR t, we get
dg
dt rg f g ÿK0: 3:24
By applying Theorems 3.5 and 3.6 we easily obtain the following conclusions:
(R1) If 06 /ÿ1K16/(which implies rP0), then for 0<K0<13; limt!1R t Rs for any initial radiusR0, that is, rs;bs;Rsis globally asymptotically stable (Fig. 1); for K0P13 we have
limt!1R t 0, and forK060 we have limt!1R t 1.
(R2) If /ÿ1K1 >/(which impliesr>0) then for 06K0 <13the solution rs;bs;Rsis again asymptotically stable (Fig. 2(a)); for K0 <K0 <0 the solution rÿs;b
ÿ
s;Rÿs is locally asymptoti-cally stable with the attraction region of Rÿs being 0;Rs, and for any R0 >Rs we have limt!1R t 1 (Fig. 2(b)). For K0P13 we have limt!1R t 0, and for K0 <K0 we have
limt!1R t 1.
(R3) If ÿ1= /16 /ÿ1K1 <0 (which implies r<0), then for 0<K0 <13 we have
limt!1R t 0 ifR0 <Rs; limt!1R t 1if R0>Rs, hence rs;bs;Rs is unstable (Fig. 3); for K0P13we have limt!1R t 1and forK060 we have limt!1R t 0.
Fig. 3.ÿ 1
/16 /ÿ1K1<0.
(R4) If /ÿ1K1<ÿ1= /1 (which impliesr<0) then, for 0<K0613 we have the same
conclusion as in (R3) (Fig. 4(a)); for 13<K0 <K0 the solution rÿs;b
ÿ
s;Rÿs is locally asymptoti-cally stable with the domain of attraction of Rÿs being 0;Rs, and for R0 >Rs we have limt!1R t 1 (Fig. 4(b)). For K0 >K0 we have limt!1R t 1 and for K060 we have
limt!1R t 0.
The rest of the paper is devoted to the extension of the above results to the non-degenerate case wherec>0;c0>0.
4. A non-extinction theorem
In cases (R1), (R2), and (R4(b)) (see Figs. 1, 2 and 4(b)) we have limt!1R t>0, so that R t
does not become extinct as t! 1. In this section, we shall extend this result to non-vanishing
c;c0, proving that lim inft!1R t>0. Note that in cases (R1) and (R2),r>0; r~<r, whereas in
case (R4(b))r~<r<0. Since we always assume that (2.7) holds (recall Corollary 2.2), in all these
three cases we haver0 <r~<r.
We now state the non-extinction result:
Theorem 4.1. If r0 <r~<r then for any e>0 there exist positive constants d0 d0 e and T0T0 e;R0 such that, if0<c6e, then
R tPd0 for all tPT0: 4:1
Remark 4.1.It is important to note that d0 is independent ofR0.
Proof.The proof is an extension and some simpli®cation of the corresponding proof for the in-hibitor-free case [9]. We choose r <0 such that
krb60 and r2 rÿr >0
and introduce the function
v r;t v r;t r r2
R t
sinh MR t
sinh Mr
r r: 4:2
Note that
vt ÿv _
R t
R tMR tcoth MR t ÿ1
and, since krb60,
cvtÿDvkvb6v (
ÿcR_ t
R tMR tcoth MR t ÿ1 kÿM 2
)
Recalling that
ÿRR_ t
t 6r~ÿmin r;r0 r~ÿr0
and using the estimate
0<ncothnÿ1<1
3n
2
8n>0; 4:4
we get, forc6e,
cvtÿDvkvb6v 1 3e r~
ÿr0M2R2 t kÿM2
: 4:5
We shall now use the function v to show that if R1 is small enough then, for any T1 >0, the
inequality
R t6R1 cannot hold for all tPT1; 4:6
hereR1 is independent of the initial radiusR0.
Indeed, otherwise we deduce from (4.5), with M2 k1, that
cvtÿDvkvb60 if 06r<R t; t>T1:
Since further vron rR t, the function
v r;t ÿAeÿk=c tÿT1 Ar
2 jr j
is a subsolution fortPT1 and, by the maximum principle,
r r;tPv r;t ÿAeÿ k=c tÿT1:
Using this in (1.16) we ®nd (as in [9]) thatR_ t>0 iftÿT1 is suciently large, and this leads to a contradiction (as in [9]).
Having proved (4.6) we conclude that for any T1>0 there exists a T2 >T1 such that
R T2>R1.
We choose positive constants d1 andM such that
d16R1 4:7
and
1
3e r~ÿr0d
2
1<1; M
2> k
1ÿ1
3e r~ÿr0d
2 1
: 4:8
Note that
ncothn11 3n
2
O n3 if n!0
so that, for some small positive constantd2,
ncothn>11
3 1ÿjn
2 if 0
where
j rÿr~ 2r2 jr j
; 0<j<1: 4:10
We shall now prove the assertion (4.1) with
d0 min
d2 M; d1j
r~ÿr0=k
; 4:11
note that d0 <d16R1.
Indeed, suppose (4.1) is not true. Then for anyT2 >0 there existst0 >T2 such thatR t0<d0.
By the assertion we proved previously, we may choose T2 such that R T2>R1. It then follows
that there exists t12 T2;t0 such that R t1 d1 and R t6d1 for all t16t<t0. We claim that
r r;tPv r;t ÿAeÿ k=c tÿt1 for 06r6R t; t16t6t0; 4:12
where v is the function de®ned in (4.2) and Ar2 jr j. Indeed, using (4.5) and the second
inequality in (4.8) we see that the right-hand side of (4.12) is a subsolution to r, so that (4.12) follows by comparison.
Now lett2 2 t1;t0be such thatR t2 d0 andR t<d0 for allt2 t2;t0; thenR_ t260. Since
_
R t=R tP ÿ r~ÿr0, we have
R tPR t1eÿ r~ÿr0 tÿt1 if tPt1
and consequently
t2 >t1log d1 d0
1= r~ÿr0
Pt1logjÿ1=k
4:13
by (4.11). Substituting (4.12) into (1.16) we get
_
R t 3
R t2
Z R t
0
r r;t ÿr~r2dr
P 3r2
R tsinh MR t
Z R t
0
rsinh Mrdrÿ r~ÿrR t ÿAR teÿk tÿt1
M32rR2 tMR tcoth MR t ÿ1 ÿ r~ÿrR t ÿAR te ÿk tÿt1:
Since R t6d0 fort26t6t0, we have MR t6Md0 <d2 by (4.11). Using also (4.9), (4.11) and
(4.13), we conclude that
_
R t> 1ÿj rÿrR t ÿ r~ÿrR t ÿjAR t if t26t6t0:
But since the right-hand side vanishes attt2, by the choicejin (4.10), this is a contradiction to
_
5. Asymptotic stability
In this section we shall extend the stability results of R1± R4to the case wherec andc0 are
non-zero, but small. Thus we shall show that in cases R1; R2; and R4 (see Figs. 1±4) the
solutions rs;bs;Rs and respectively, rÿs;bÿs;Rÿs, are globally asymptotically stable and, re-spectively, locally asymptotically stable with domain of attraction 0;R
s ÿd for any d>0, provided cand c0 are positive and suciently small.
We ®rst need to establish an upper bound on the solution, and this requires the following lemma:
Lemma 5.1. Let r r;t; b r;t; R t be the solution of(1.12)±(1.18) for 06t; T0 0<T061
and set
w r;t
bR t
sinh pcR t
sinh pcr
r ; 5:1
v r;t 1ÿK1
rR t
sinh pcR
t
sinh pcr
r K1
rR t
sinh pcR
t
sinh pcr
r : 5:2
Assume that jR_ t j 6L for06t<T0 and
j u0 r ÿv r;0 j 6M; ju0 r ÿw r;0 j 6M for 06r6R0: 5:3
Then there exist positive constants C (depending only onk;c;r;band a (depending only onk;c) such that
jb r;t ÿw r;t j 6C Lc0Meÿct=c0
; 5:4
j r r;t ÿv r;t j 6C Lc00Meÿat=c00 c00cc0 5:5 for 06r6R t;06t<T0.
Proof.As easily veri®ed
c0wtÿDwcw ÿc0R_ t cR tp pcR t w;
where the functionp g is de®ned in (3.10). By Lemma 3.2
0<cR tp pcR
t6pc;
and since 0<w6b, we get
j c0wtÿDwcwj 6Lbpcc0: Consequently, by comparison,
b r;t ÿw r;t6 L
bpcc0
c ; 5:6
Similarly,
On the other hand, by (5.4),
jcrtÿDrkrwj 6 Theorem3.6.Let K anddbe positive constants such that one of the following three conditions holds: (i) KPdmaxfR0;Rsgif either 06 /ÿ1K16/; 0<K0 <13 or /ÿ1K1>/; 06K0 <13;
Proof.The assumptions on /;K1 imply that
and that
either r>0 and f pkK6K0ÿd~ or r<0 and f
k p
KPK0d~; 5:8
whered~depends on the same constants on which e0 is asserted to depend on.
Suppose that (5.7) is not true. Then, sinceK>R0, there exists at0 >0 such that (5.7) holds for allt<t0 and R t0 K. Consequently,
_
R t0P0 5:9
and, by Theorem 2.1,
t0P 1
Alog
K R0 >
1
Alog
K
Kÿdt >0: 5:10
By Theorem 2.1 we also have
jR_ t j 6L if 0<t6t0; 5:11
where
Lmaxfjrÿr~jK; jr~ÿr0 jKg: 5:12
It follows thatt and Ldepend on the same constants upon whiche0 is asserted to depend on.
We now apply Lemma 5.1 to obtain the inequalities
v r;t ÿC c00eÿat=c006r r;t6v r;t C c00eÿat=c00 5:13
for 06r6R t;0<t6t0, wherevis the function de®ned in (5.2). Substituting the upper bound on rinto (1.16) and setting g t pkR t, we get
dg t
dt 6rg t f g t ÿK0 Cg t c
00eÿat=c00
: 5:14
Takingtt0 and using (5.8) and (5.10) we getg_ t0<0 ifc006e0 ande0is small enough, which is
a contradiction to (5.9).
We now state the main result of this section which asserts, for c;c0 small enough, the same
stability results that hold in the casecc00 (see Figs. 1±4).
Theorem 5.3. Let r r;t; b r;t;R t and Rs;Rÿs;Rs be as in Theorem 5.2. Suppose the initial radiusR0 satisfies, for some smalld>0, one of the following three conditions:
(i) 0<R061=d if either 06 /ÿ1K16/; 0<K0 <13 or /ÿ1K1 >/; 06K0 <13;
(ii) 0<R06Rs ÿd if either /ÿ1K1 >/; K0 <K0<0 or /ÿ1<ÿ1= /1; 1
3<K0<K0 ;
(iii) 0<R06Rsÿd if either ÿ1= /16 /ÿ1K1 <0; 0<K0 <13 or /ÿ1K1 <ÿ1=
/1; 0<K0613.
lim
t!1R t
Rs in case i;
Rÿ
s in case ii;
0 in case iii;
8 <
:
5:15
moreover, the convergent is exponentially fast.
We shall ®rst prove Theorem 5.3 in case (iii).
Proof of (5.15) in case (iii).Take a constantKsuch that it satis®es the conditions in Theorem 5.2 (withdreplaced byd=2). By Theorem 5.2,R t6Kfor allt>0 providedcc06e
0; e0suciently
small, and then (5.11)±(5.14) follow as before. Recall that in case (iii)
r6r~<0 and f pkR0>K0:
Fixt0 suciently small (independently of e0) so that, by Theorem 2.1,
R t6R0eÿr~t <K for 06t6t0:
Then
f g t ÿK0Pb0>0 b0 constant 5:16
for all 06t6t0. On the other hand from (5.14) we get
_
g t6rg tf g t ÿK0 Ce0g t if tPt0:
Choosing e0 <jrjb0= 2C we deduce thatg_ t<0 at tt0 and then, by continuity, g_ t<0 in
some interval t0;t0s, so that g t6g t0<
k p
K and
_
g t<rg tf g t ÿK0 ÿ
1
2rb 0g t 5:17 in this interval. We can now repeat the previous step and deduce, step-by-step, thatg_ t<0 and (5.17) holds for all tPt0, so that g t !0 as t! 1 (and, in fact, exponentially fast since the right-hand side of (5.17) remains 6 ÿ 1=2rb 0g t.
Remark 5.1.The above proof shows thatR t decreases monotonically (to zero) for alltP0.
We next consider case (i) of Theorem 5.3.
Lemma 5.4. Consider case (i) of Theorem 5.3. Then for an arbitrary a0 >0 there exist positive
constants C,b and (sufficiently small) e0 depending only on k;c;r;r~;b;d anda0, such that the
fol-lowing is true ifc00cc06e0: For any0<a6a0, if the inequalities
jR t ÿRs j 6a; jR_ t j 6a;
jr r;t ÿrs r j 6a; jb r;t ÿbs r j 6a
5:18
hold for all 06r6R t; tP0then also the inequalities
jR t ÿRs j 6Ca c00eÿbt; jR_ t j 6Ca c00eÿbt; jr r;t ÿrs r j 6Ca c00eÿbt; jb r;t ÿb
s r j 6Ca c00eÿbt
5:19
Proof.From Lemma 5.1 we get
j r r;t ÿv r;t j 6Ca c00eÿat=c00 8tP0; 5:20
j b r;t ÿw r;t j 6Ca c00eÿct=c00
8tP0: 5:21
Substituting (5.20) into (1.16) and settingg t pkR t, we get
j g_ t ÿrg tf g t ÿK0 j 6Cag t c00eÿat=c 00
8tP0: 5:22
Consider ®rst the case 06 /ÿ1K16/. Then r>0 and
f0 g<0 for all g>0: 5:23
By Theorems 4.1 and 5.2 we know that there are positive constantse0; T0; d0 andKindependent
ofc; c0 anda (but dependent on a
0) such that ifc006e0 then
d06g t6K for all tPT0: 5:24
Consequently, by the mean value theorem,
rg tf g t ÿK0
6 ÿC0 g t ÿgs if g tPgs; P ÿC0 g t ÿgs if g t<gs;
5:25
wheregspkRs andC0 is a positive constant depending only onr;d0;K and the coecients of f g. We shall use this inequality to prove that there exist positive constantsm; Bindependent of
c; c0, and a such that
jg t ÿgs j<Ba c00eÿmt
for alltP0: 5:26 It is clear that (5.26) holds for all 06t6T0 if, for ®xed m>0;B is chosen suciently large. Therefore, if (5.26) is not true, then there exists at0 >T0 such that
gsÿBa c00eÿmt
<g t<gsBa c00eÿmt
for 06t<t0
but not fortt0; for de®niteness suppose that
g t0 gsBa c00eÿmt0; 5:27
then also
_
g t0 mBaeÿmt0P0: 5:28
On the other hand, by (5.22) and (5.25),
_
g t06 ÿC0 g t0 ÿgs Cag t0 c00eÿat0=e0:
Substituting (5.27) and (5.28) into this inequality and using the factg t06K we get
ÿmBaeÿmt06 ÿC0Ba c00eÿmt0 CKa c00eÿat0=e0;
which is a contradiction if we choose m suciently small, say m6min C0=2;a=e0, and B
corre-spondingly large. Having proved (5.26), the other estimates in (5.19) easily follow.
It remains to consider the case /ÿ1K1 >/. Again we have r>0. But now (5.23) is not
valid. However, if we denote byg0 the stationary point off g, then we still have
so that ifR0 <R g0=
k p
then the previous argument still works for the present situation. If on the other hand R0PR, then f g 0<0 and thus g t remains in the region where f g is negative when t varies in a small interval 0;t0. Using (5.22) for tPt0 we conclude that if
c006e0; e0 is suciently small, then as long asg tPg0ÿ2d0 (for some smalld0>0) we have
_
g t6 ÿb0g t
(for some positive constantb0). Thus there exists a timetPt0 such thatg tlies in 0;g0ÿd0at tt. We can then proceed as in the former case to establish (5.26).
Having proved Lemma 5.4, we can now apply it successively in [9] (over intervalstn;1) with increasing n) and establish (5.15) in case (i).
We shall next extend Lemma 5.4 to case (ii).
Lemma 5.5. Consider case (ii) of Theorem 5.3. Then for an arbitrary a0 there exist positive
con-stants C,b and (sufficiently small)e0 depending onk;c;r;r~;b;danda0such that the following is true
if c00cc06e
0: For any0<a<a0, if the inequalities
jR t ÿRÿs j 6a; jR_ t j 6a;
jr r;t ÿrÿ
s r j 6a; jb r;t ÿbÿs r j 6a
5:29
hold for all 06r6R t; tP0then also the inequalities
jR t ÿRÿ
s j 6Ca c00eÿ
bt; jR_ t j 6Ca c00eÿbt;
jr r;t ÿrÿs r j 6Ca c00eÿbt; jb r;t ÿbÿ
s r j 6Ca c00eÿ
bt 5:30
hold for all 06r6R t; tP0.
Proof.The proof is similar to the proof of Lemma 5.4 for the case /ÿ1K1 >/.
Again, by using Lemma 5.5 and following a similar argument as in [9] we can derive the as-sertion (5.15) in case (ii).
6. Instability: unboundedness ofR(t)
We shall use the notation
wl r;t
R t
sinh plR t
sinh plr
r for any l>0; 6:1
where r r;t;b r;t;R tis the solution of (1.12)±(1.18). We set
w r;t bwc r;t; 6:2
v r;t rf 1ÿK1wk r;t K1wc r;tg 6:3
and
w0 r w r;0; v0 r v r;0: 6:4
In this section, we consider essentially all the cases that were not covered by the stability results of Section 5. We can divide them into four disjoint cases:
(i) 06 /ÿ1K16/; K0 <0; 0<R0 <1;
(ii) /ÿ1K1>/and either K0 <K0<0; R0>Rs or K0<K0; 0<R0<1;
(iii)ÿ1= /16 /ÿ1K1 <0 and either K0P13; 0<R0<1, or 0<K<13; R0>Rs, and (iv) /ÿ1K1 <ÿ1= /1 and 0<K0631; R0>Rs, or 13<K0 <K0 ; R0 >Rs, or K0>K0 ; 0<R0<1.
We want to show that if one of these conditions is satis®ed then there are initial datau0 r;w0 r
for whichR t ! 1ast! 1. We take u0;w0 such that
u0 r ÿ 1
cÿkw0 rP rÿ b cÿk
!
R0sinh k p
r
rsinh pkR0; 6:5
w0 r
P
bR0sinh pcr
rsinh pcR0 if c>k;
6
bR0sinh pcr
rsinh pcR0 if c>k 8
> > > <
> > > :
6:6
and
Dw0 r ÿcw0 r60 6:7
for 06r6R0.
Theorem 6.1. Assume that one of the conditions i;. . .; ivis satisfied and that(6.5)±(6.7)hold. If
0<c06c6e0 whene0 is sufficiently small depending on the parameter setA, then
_
R t>0 for all t>0; 6:8
R t ! 1 if t! 1: 6:9
Remark 6.1.The conditionc06cis a technical limitation of the proof. It means that the inhibitor diuses faster than the nutrient.
Remark 6.2. From the proof of the theorem it follows that if one of the conditions (i)±(iv) is satis®ed withR0ÿdinstead ofR0, for somed>0, thene0 depends ondbut not on the speci®cR0.
We shall need the following lemma:
Lemma 6.2. Under assumptions of Theorem6.1,for any givenM1 >R0there existe0>0andT0 >0
such that
_
R t>0 if 06t6T0 and R T0PM1;
Proof.From (6.5) and (6.6) it follows that
u0 rP 1ÿK1rR0sinh k p
r
rsinh pkr K1
rR0sinh pcr
rsinh pcR0
: Substituting this into (1.16) we get
_
R 0PrR0f pkR0 ÿK0>0:
Hence there exists a t0 >0 such that R_ t>0 for 06t6t0. Now, for a given M1>R0, let
T0 1=l0log M1=R0 t0, where
l0
1 2rf
k p
R0 ÿK0>0:
From Theorem 2.1 we see that for all 06t6T0,
R t6R0eAT0 Amax r;0 ÿr~>0;
which implies
jR_ t j 6A1R0eAT0 for all 06t6T0;
where A1 is a constant depending only onr; r~ and r0. Therefore, applying Lemma 5.1 (taking M b) we get
r r;tPv r;t ÿCc00 for all t06t6T0;
wherec00cc0 andCis a constant depending only onA; t0 and T0. Substituting this estimate
into (1.16) we ®nd, as before, that
_
R tPR tfrf pkR t ÿK0 ÿCc00g for all t06t6T0:
From this inequality, it follows that, providedc006e
0 l0=C, as long asR_ tremains positive for tPt0 and 6T0 we have R t>R0, so that
r f pkR t ÿK0P2l0
and thus R_ tPl0R t>0. Finally, integrating the last inequality in the interval t06t6T0 and using the de®nition ofT0 we obtain the assertion R T0PM1.
Proof of Theorem 6.1.We shall specifyM1later on, and thene0andT0 will be chosen, accordingly,
as in Lemma 6.2. Let t be any number larger than T0 such that
_
R t>0 if 06t<t: 6:10
If we prove thatR_ t>0, then a continuity argument shows that (6.8) is satis®ed. Then also (6.9) holds since, otherwise, Rlim
t!1R t<1 and the corresponding limits of r r;t;b r;t as t! 1 (which exist by standard parabolic theory [10]) form a stationary solution, which is a contradiction.
Notice that (6.10) implies that
To prove thatR_ t>0 we consider ®rst the caser>0 (Figs. 1 and 2) and divide it into three cases. The ®rst one is
a: c>k; rP b cÿk;
i.e.,/>1; 06K161 (for this case Lemma 6.2 is not needed). Since R_ tP0 for 06t6t,
c0wtÿDwcw60 if 06r6R t; 06t6t: 6:12
We claim that
bt r;t60 if 06r6R t; 06t6t: 6:13
Indeed, the functionubt satis®es
c0utDuÿcu
and by dierentiating (1.14),
ou
or 0;t 0; u R t;t ÿbr R t;tR_ t60;
sinceR_ tP0 andbr R t;t>0 by the maximum principle. Finally (6.7) ensures thatu r;060 and, then, (6.13) follows by the maximum principle applied tou.
From (1.13) and (6.13) we deduce that
cbtÿDbcb cÿc0bt60 6:14
so that, by comparison,
b r;tPw r;t: 6:15
Consider next the function
z r;t r r;t ÿ 1
cÿkb r;t: 6:16
By (1.12) and (6.14) we have
cztÿDzkzP0
and sincerÿb= cÿkP0,
z r;tP rÿ b cÿk
!
wk r;t
by comparison. Combining this with (6.15) we conclude that
r r;t z r;t 1
cÿkb r;tPv r;t:
Substituting this estimate into (1.16) we obtain the inequality
_
R tPrR tf pkR t ÿK0 for 06t6t;
and since
f pkR t ÿK0 >0;
In the sequel we shall use the fact that
The proof is by comparison. If we denote the right-hand side byuand the left-hand side byv, then
Dvÿlv0; Duÿlu kÿluP0 if 06r6R;
e0 small enough so that
1ÿK1p
kM1
e0AM1pk
>K0
(e0 has also to be small enough as required by Lemma 6.2). Recalling that K1 is positive, p is
monotone decreasing and thatMPM1, we then also have
by condition (b), (6.18) and (6.21) and the inequalityncothnÿ16n. Also
Substituting this estimate into (1.16) and using (6.19) we obtain, attt,
_
e0 is also chosen small enough as required in Lemma 6.2.
Let
and proceeding as in the case ofZ above, we deduce, using (6.24), that
Since also
In case (a0) we chooseM1 suciently large ande
0 small so that, forMPM1,
Next we proceed to estimatezfrom below by Zand use (6.15), in order to derive a lower bound onr, which leads to R_ t>0 (by (1.16) and (6.29)).
We ®nally note that the case r0 can be handled similarly to the case r>0, orr<0:
Remark 6.3.Throughout this paper we assume thatc6k. For completeness we mention that the caseck or /1, can be handled by letting /!1. By L'Hospital's rule we ®nd that
f g p g b kr
gp0 g 2
and the stability and instability of stationary solutions follows by the same analysis as above applied to this limit function f.
7. The eect of inhibitor's parameters on tumor's growth
We may view the parameterK0as the tumor's characteristic (without inhibitors), the parameter
c as the inhibitor's (drug) characteristic, and the parameterbas the external inhibitor (normal-ized) concentration. In this section, building upon the mathematical results of Sections 3±6, we shall determine how the tumor's growth depends upon the parameters band c (or /; this will suggest a strategy for drug treatment.
Note that we are concerned here with large time progress of the therapy and therefore the parametersc and c0 will not play a role in the discussion of the drug treatment, we assume that they are small enough as in Sections 5 and 6.
By (1.19) we can write
K1
1 kr
b
/2ÿ1; /
c k r
: 7:1
We shall ®rst consider the case
r>0; 7:2
we are then in the situations described in Figs. 1 and 2. Assumption (7.2) implies that
K1 >0 if and only if />1;
K1 <0 if and only if /<1;
7:3
a property that we shall often be using in the sequel. According to Section 3, stationary solutions exist in just two cases:
CaseA. 0<K0<13 (Figs. 1 and 2(a)).
CaseB. K0<K0 <0 (Fig. 2(b))
(we omit for simplicity that casesK0 0;K0 K0).
gÿ pkRÿs; gpkRs Rÿs <Rs;
the one with smaller radius is asymptotically stable if R0 <Rÿs and the one with larger radius is unstable and, in fact, for the time-dependent solution, if R0 >Rs then R t may grow to 1 as
t! 1.
Taking (7.1) into consideration, we can rewrite the functionf gde®ned by (3.11) and (3.10) as follows:
f g p g b kr
p /g ÿp g
/2ÿ1 ; /
c k r
: 7:4
We shall writef gasf g;b;/to emphasize the dependence on the relevant parameters regarded as independent variables. We shall indicate the dependency ofg and g on b;/;c by writing
gg b;/ gb;c;
gg b;/ gb;c: 7:5
At the point g0, wheref takes its minimum (Theorem 3.5(ii)) we have
of
og gg0
p0 g0 b kr
/p0 /g0 ÿp0 g0
/2ÿ1 0: 7:6
We shall write g0 g0 b;/and denote the minimum of f by K0K0 b;/ K0b;c, so that
K0K0 b;/ f g0 b;/;b;/: 7:7
The following lemma will play an important role in our discussion:
Lemma 7.1. For each fixedg>0; the function
hg / p /g ÿp g= /
2
ÿ1 for /61 />0;
1=2gp0 g for /1
7:8
is continuous and strictly monotone increasing for />0.
Proof.The continuity ofhg /follows by L'Hospital's rule (cf. Remark 6.3). To prove thathg /
is strictly monotone increasing we compute its derivative in /,
h0g / /
2
ÿ1gp0 /g ÿ2/p /g ÿp g
/2ÿ12 for /61: 7:9
Thus we only need to prove that for all /61 />0,
gg / /2ÿ1gp0 /g ÿ2/p /g ÿp g>0: 7:10
We compute
g0g / /2ÿ1g2p00 /g ÿ2p /g ÿp g; 7:11
lim
/!1
gg /
/ÿ12 ggp
From Lemma 3.3 and the fact that limg!0k g 1 we see thatk g<1 if g>0, i.e.,
gp00 g
p0 g <1 if g>0: 7:13
Hence (7.12) yields
gg />12 /ÿ1
2
ggp00 g ÿp0 g>0;
if/2 1ÿd;1d n f1g, for some smalld>0.
Assume now that (7.10) is not true for all/P1d. Then there exists a /0>1dsuch that gg />0 if 1</</0, andgg /0 0; this implies thatg0g /060. On the other hand we have,
by (7.11),
gg0 /0 /02ÿ1g2p00 /
0g ÿ2p /0g ÿp g
/20ÿ1g2p00 /0g ÿ
/20ÿ1 /0 gp
0 /
0g since gg /0 0
/
2
0ÿ1g
/0 /0gp
00 /
0g ÿp0 /0g>0 by 7:13;
a contradiction.
Similarly one can prove that (7.10) is true for all 0</<1.
Theorem 7.2. The following properties hold:
o
obK
0b;c<0; 7:14
o
ocK
0b;c>0; 7:15
lim
b!1
K0b;c ÿ1: 7:16
Proof.Since
of
og gg0
0
we have, by (7.7) and (7.4),
oK
0
ob of
ob g0;
b;/ 1 kr
p /g0 ÿp g0 /2ÿ1 <0;
oK
and (7.15) follows. Finally, to prove (7.16) we take any 0<g<1 and write
K0f g0;b;/6f g;b;/ p g b kr:
p /g ÿp g /2ÿ1 :
Since p g is strictly monotone decreasing andr>0, we see that
1 kr
p /g ÿp g
/2ÿ1 <0 7:17
and (7.16) readily follows.
Theorem 7.3. Assume that (7.2)holds and that either 0<K0 <13 or K0<K0 <0: Then
Dierentiating this equation with respect to band/, respectively, we get
Sinceof=og
gg b;/<0
(by Theorem 3.5), the inequalities in (7.18) follow immediately from (7.8)
and (7.17) and from Lemma 7.1. The inequalities (7.19) and (7.20) can be proved in a similar way. Next let us prove (7.21). From (7.18) we see that
g lim
b!1
gb;c
exists and is non-negative and ®nite. If this number is positive then, by dividing (7.24) byband letting b! 1, we obtain
1 kr
p /g ÿp g
/2ÿ1 0
which is a contradiction sincep g is strictly monotone decreasing. Hence we must haveg0,
and (7.21) is proved. The relations (7.22) and (7.23) can be proved in the same way.
Let us now examine the results obtained above from the point of view of medical treatment of tumours. If 0<K0 <13then there exists a unique dormant tumor, and it is globally asymptotically
stable; Theorem 7.3 tells us that its radius decreases as bis increased. If K0 <0 then the tumor
becomes unbounded (and R t ! 1 as t! 1) when there is no inhibitor. However, in the presence of inhibitor, Theorem 7.2 tells us that if the external concentrationbexceeds a certain critical number b then two dormant states appear with radii Rÿs and Rs; Rÿs <Rs; Rÿs is as-ymptotically stable, and R t !Rÿs as t! 1, providedR0 <Rs. On the other hand if R0 >Rs
then (at least for some initial data) R t grows to 1 ast! 1. Given initial radius R0, the last
conclusion of Theorem 7.3 asserts that we can increasebso thatRs Rs b(which is dependent onb) will satisfyR
s b>R0and then indeedR t !Rÿs bast! 1. The constantb
for which
Rs b>R0whenb>bwill of course depend onR0, butbdoes not depend onR0. Finally, when
bkeeps increasing, Rÿ
s b keeps decreasing, and Rÿs b !0 as b! 1.
In conclusion, by increasing the amount of drug concentration b we can always decrease the tumour and in fact, render its limiting size arbitrarily small; the smallest concentration that ensures containment of the tumour isbb, and it is a function of its initial radius R0.
Theorems 7.2 and 7.3 also show that decreasingchas a similar eect as increasingb: the smaller thec, the more eective the drug is; if cis decreased then the limiting R t is also decreased.
Remark 7.1.So far we have assumed that (7.2) holds. Consider next the case
r<0 Figs: 3 and 4: 7:25
If 0<K0 <13 then there is just one dormant state with normalized radiusg, and if13<K0 <K0
then there are two dormant states with normalized radiigÿ andg, wheregÿ<g. Proceeding as
in the case of (7.2), one can prove that
o
obK
0 b;c>0;
o
ocK
0 b;c<0;
lim
b!1K
o
eect: if bis increased beyond a critical number bso that
g
0 . Here again a drug with smallercis more eective: ifcis decreased then the limiting R tis also decreased.
We ®nally note that the caser0 can be handled as a limit case of eitherr>0 orr<0.
8. Conclusion
We have show that, for ®xed K0, the number of dormant tumors depend on the parameters
K1;/de®ned in (1.19), or on the intrinsic inhibitor-parametercand its external concentrationb.
There may be one, two or no dormant states. In the cases where dormant states exist, we de-termined by rigorous mathematical analysis which of them is asymptotically stable and which is unstable; when two dormant states exist, the smaller one is stable and the larger one is unstable. We established monotonic dependence of the tumor's radius on the parameters b and c. Our analysis suggests how the external concentration bshould be chosen.