TRANSFORMING FRACTURE RISK
ASSESSMENT FOR CANCER PATIENTS
WITH VERTEBRAL METASTASES
Computer-aided effective fracture risk stratification of patients with vertebral metastases for personalised treatment through robust computational models validated in clinical settings

Medical Professionals

METASTRA is a pioneering initiative, funded by the European Union through the Horizon Europe program, specifically the "Tools and Technologies for a Healthy Society" call. Led by the University of Bologna, this collaborative effort brings together a consortium of 15 institutions from various European Member States, with a substantial total funding allocation of 6.7 million EUR over a five-year period. Our meticulously crafted work plan and multidisciplinary research team are dedicated to advancing the field of medical care in this specialised domain.

Within the European healthcare context, advancements in early cancer diagnosis and treatment modalities have contributed significantly to enhanced life expectancies among cancer patients. Nevertheless, approximately 1 million individuals grapple with the challenges of secondary tumour growth, with bone metastases manifesting in a substantial percentage, ranging from 30% to 70%, of these cases. These metastases often result in a marked reduction in spinal load-bearing capacity and, concerningly, precipitate fractures in around 30% of affected patients. Current clinical decision-making options are limited and subject to uncertainty, primarily revolving around surgical intervention for spinal stabilisation or accepting a heightened risk of fractures, both of which have profound implications for patient well-being and ongoing cancer treatment.

The prevailing standard of care relies predominantly on scoring systems rooted in radiographic imagery, with limited consideration for the intricacies of local biomechanics. Regrettably, these approaches fail to offer precise surgical indications in nearly 60% of cases, underscoring the pressing need for more accurate risk quantification and patient stratification methodologies.

In response to this unmet need, METASTRA is committed to developing innovative computational models that harness the power of Artificial Intelligence (AI) and Physiology-based (VPH) mechanical principles. These models aim to accurately stratify patients with vertebral metastases who are at a high risk of fractures, facilitating the identification of personalised surgical interventions.

To support clinical decision-making processes, METASTRA will seamlessly integrate these computational models into a user-friendly Decision Support System (DSS) designed to meet regulatory standards and potential future commercialization requirements. Our innovative guidelines for patient stratification and management hold the potential to substantially reduce the rate of uncertain diagnoses, from the current 60% to a mere 20% of cases. This breakthrough has the potential to alleviate patient suffering and significantly impact healthcare costs, with potential annual savings of up to 2.4 billion euros.

In conclusion, METASTRA represents a pioneering effort to address the complex challenges associated with fracture risk assessment in cancer patients with vertebral metastases. We are committed to advancing the field of personalised medicine and improving the lives of patients in need.