CNIO researchers Miguel Quintela, project coordinator (right), and Leonardo Garma /Laura M. Lombardía. CNIO
The project, still under development, seeks to create 'digital twins' - virtual replicas of patients - that would eventually enable to personalize treatments and to accurately anticipate the evolution of the disease.
150 women with advanced cancer are already taking part in the pioneering study. The aim is not to treat them, but to generate tools and knowledge that lead to a more precise and personalized oncology in the future.
‘Digital Twins’ is part of the IMPaCT Precision Medicine Infrastructure, promoted by the Carlos III Health Institute (ISCIII). It is financed with publich funding worth 2.5 million euros.
A project led by the Spanish National Cancer Research Center (CNIO), in collaboration with nine hospitals from all over Spain, two universities (listed below) and the CRIS Against Cancer Foundation, is taking significant steps towards personalized medicine. To date, 150 women with advanced cancer are already part of this pioneering study. They represent half of the total target number of participants.
The project is part of the the IMPaCT Infrastructure for Precision Medicine, promoted by the Carlos III Health Institute (ISCIII), which also provides funding.
El objetivo es desarrollar réplicas virtuales mediante inteligencia artificial, las llamadas gemelas digitales, de mujeres con cáncer avanzado. Se trata de sentar las bases para que, en futuros ensayos, pueda personalizarse más el tratamiento, y anticiparse a la evolución del cáncer.
The aim is to develop, using artificial intelligence, virtual replicas of women with advanced cancer. These so-called digital twins should lay the foundations for future trials that eventually enable more personalized treatements and an anticipation of tumor evolution.
What is a digital twin and how can it impact cancer treatment?
A digital twin is a virtual model that seeks to accurately replicate a patient’s health status in real time. Unlike traditional medical records, this twin integrates multiple layers of information, including:
– Tumor molecular data (DNA, proteins, metabolism…),
– Real-time body indicators collected with smart watches (heart rate, sleep, physical activity),
– Emotional and quality-of-life information collected through an app,
– Conventional clinical data, such as treatments and analyses.
These data are constantly updated to allow researchers and clinicians to better understand the evolution of the disease and the impact of treatment on each patient, predict side effects and adjust therapies in real time.
Half of the patients are already being monitored
The study, in which 9 hospitals from all over Spain and two universities (Politécnica de Madrid and Universidad Carlos III) are participating, plans to include 300 women with metastatic breast, lung or colon cancer, just before starting their treatment. With 150 women already recruited, this marks a crucial moment in the viability of the project.
The first results, presented at the ESMO congress, show that it is possible to perform high-quality remote monitoring, and that the obtained data are robust enough to train computational models that will make it possible to predict how patients’ disease will develop.
The research team is already preparing to present next results at the ASCO 2025 congress, which will take place in Chicago and represents the largest oncology meeting in the world. There they will discuss how remotely collected data – from daily activity to emotional states – can help anticipate early response to treatment in metastatic cancer.
Incorporating biological age: a new layer of accuracy
One of the most innovative aspects of this project is that it not only measures what happens in the tumor, but also how the patient’s body ages during treatment. Thanks to a new biological clock model, also developed at the CNIO, it is possible to estimate the real biological age of the organism from DNA.
This molecular clock accurately detects whether the patient’s body is aging faster than expected, which may be influenced by the type of tumor, the toxicity of treatments or even emotional factors. With this information, physicians could better assess the impact of treatment, and adjust the intensity or combination of therapies according to each person’s biological situation.
This is the first time that this tool has been incorporated in a practical way into a real clinical follow-up study.
A project focused on the medicine of the future
Although this project is still in the development phase and does not have a curative purpose for the participating patients, it does seek to generate tools and knowledge to transform the medicine of the future. Thanks to the combination of molecular data, remote monitoring and measurement of biological age, it opens the door to a more precise oncology adapted to each individual.
It is one of the most ambitious personalized medicine initiatives in Spain. Led by the CNIO and funded with 2.5 million euros over three years, this public research project, technically called High-definition oncology in women’s cancer, is a personalized precision medicine project financed by the Instituto de Salud Carlos III (ISCIII) with funds from the European Union (NextGenerationEU/PRTR). It is part of the IMPaCT (Infrastructure for Precision Medicine associated with Science and Technology) initiative of the ISCIII.
Participants:
CNIO; La Princesa Hospital; Fuenlabrada Hospital; Valencia University Hospital; Son Espases Hospital; ICO Bellvitge; Navarra Hospital Group; Virgen de la Macarena Hospital; San Pedro Hospital in Cáceres; A Coruña Hospital Group; Carlos III University; Technical University of Madrid; and CRIS Against Cancer Foundation.
About the Spanish National Cancer Research Center (CNIO)
The Spanish National Cancer Research Center (CNIO) is a public research center under the Ministry of Science, Innovation and Universities. It is the largest cancer research center in Spain and one of the most important ones in Europe. It integrates half a thousand scientists, plus support staff, who work to improve cancer prevention, diagnosis and treatment.