Predictive models for patients with lung carcinomas to identify EGFR mutation status via an artificial neural network based on multiple clinical information

AI models for the identification of prognostic and predictive biomarkers in lung cancer: a systematic review and meta-analysis

Introduction

This systematic review and meta-analysis aim to evaluate the efficacy of artificial intelligence (AI) models in identifying prognostic and predictive biomarkers in lung cancer. With the increasing complexity of lung cancer subtypes and the need for personalized treatment strategies, AI-driven approaches offer a promising avenue for biomarker discovery and clinical decision-making.

Methods

A comprehensive literature search was conducted in multiple electronic databases to identify relevant studies published up to date. Studies investigating AI models for the identification of prognostic and predictive biomarkers in lung cancer were included. Data extraction, quality assessment, and meta-analysis were performed according to PRISMA guidelines.

Results

A total of 34 studies met the inclusion criteria, encompassing diverse AI methodologies and biomarker targets. AI models, particularly deep learning and machine learning algorithms demonstrated high accuracy in predicting biomarker status. Most of the studies developed models for the prediction of EGFR, followed by PD-L1 and ALK biomarkers in lung cancer. Internal and external validation techniques confirmed the robustness and generalizability of AI-driven predictions across heterogeneous patient cohorts. According to our results, the pooled sensitivity and pooled specificity of AI models for the prediction of biomarkers of lung cancer were 0.77 (95% CI: 0.72 - 0.82) and 0.79 (95% CI: 0.78 - 0.84).

Conclusion

The findings of this systematic review and meta-analysis highlight the significant potential of AI models in facilitating non-invasive assessment of prognostic and predictive biomarkers in lung cancer. By enhancing diagnostic accuracy and guiding treatment selection, AI-driven approaches have the potential to revolutionize personalized oncology and improve patient outcomes in lung cancer management. Further research is warranted to validate and optimize the clinical utility of AI-driven biomarkers in large-scale prospective studies.

Clinical application of artificial neural network (ANN) modeling to predict BRCA1/2 germline deleterious variants in Chinese bilateral primary breast cancer patients

BACKGROUND

Bilateral breast cancer (BBC), as well as ovarian cancer, are significantly associated with germline deleterious variants in BRCA1/2, while BRCA1/2 germline deleterious variants carriers can exquisitely benefit from poly (ADP-ribose) polymerase (PARP) inhibitors. However, formal genetic testing could not be carried out for all patients due to extensive use of healthcare resources, which in turn results in high medical costs. To date, existing BRCA1/2 deleterious variants prediction models have been developed in women of European or other descent who are quite genetically different from Asian population. Therefore, there is an urgent clinical need for tools to predict the frequency of BRCA1/2 deleterious variants in Asian BBC patients balancing the increased demand for and cost of cancer genetics services.

METHODS

The entire coding region of BRCA1/2 was screened for the presence of germline deleterious variants by the next generation sequencing in 123 Chinese BBC patients. Chi-square test, univariate and multivariate logistic regression were used to assess the relationship between BRCA1/2 germline deleterious variants and clinicopathological characteristics. The R software was utilized to develop artificial neural network (ANN) and nomogram modeling for BRCA1/2 germline deleterious variants prediction.

RESULTS

Among 123 BBC patients, we identified a total of 20 deleterious variants in BRCA1 (8; 6.5%) and BRCA2 (12; 9.8%). c.5485del in BRCA1 is novel frameshift deleterious variant. Deleterious variants carriers were younger at first diagnosis (P = 0.0003), with longer interval between two tumors (P = 0.015), at least one medullary carcinoma (P = 0.001), and more likely to be hormone receptor negative (P = 0.006) and HER2 negative (P = 0.001). Area under the receiver operating characteristic curve was 0.903 in ANN and 0.828 in nomogram modeling individually (P = 0.02).

CONCLUSION

This study shows the spectrum of the BRCA1/2 germline deleterious variants in Chinese BBC patients and indicates that the ANN can accurately predict BRCA deleterious variants than conventional statistical linear approach, which confirms the BRCA1/2 deleterious variants carriers at the lowest costs without adding any additional examinations.

Artificial intelligence-based prediction of clinical outcome in immunotherapy and targeted therapy of lung cancer

Lung cancer accounts for the main proportion of malignancy-related deaths and most patients are diagnosed at an advanced stage. Immunotherapy and targeted therapy have great advances in application in clinics to treat lung cancer patients, yet the efficacy is unstable. The response rate of these therapies varies among patients. Some biomarkers have been proposed to predict the outcomes of immunotherapy and targeted therapy, including programmed cell death-ligand 1 (PD-L1) expression and oncogene mutations. Nevertheless, the detection tests are invasive, time-consuming, and have high demands on tumor tissue. The predictive performance of conventional biomarkers is also unsatisfactory. Therefore, novel biomarkers are needed to effectively predict the outcomes of immunotherapy and targeted therapy. The application of artificial intelligence (AI) can be a possible solution, as it has several advantages. AI can help identify features that are unable to be used by humans and perform repetitive tasks. By combining AI methods with radiomics, pathology, genomics, transcriptomics, proteomics, and clinical data, the integrated model has shown predictive value in immunotherapy and targeted therapy, which significantly improves the precision treatment of lung cancer patients. Herein, we reviewed the application of AI in predicting the outcomes of immunotherapy and targeted therapy in lung cancer patients, and discussed the challenges and future directions in this field.