Artificial Intelligence to Decode Cancer Mechanism: Beyond Patient Stratification for Precision Oncology

A comprehensive review of machine learning techniques for multi-omics data integration: challenges and applications in precision oncology

Multi-omics data play a crucial role in precision medicine, mainly to understand the diverse biological interaction between different omics. Machine learning approaches have been extensively employed in this context over the years. This review aims to comprehensively summarize and categorize these advancements, focusing on the integration of multi-omics data, which includes genomics, transcriptomics, proteomics and metabolomics, alongside clinical data. We discuss various machine learning techniques and computational methodologies used for integrating distinct omics datasets and provide valuable insights into their application. The review emphasizes both the challenges and opportunities present in multi-omics data integration, precision medicine and patient stratification, offering practical recommendations for method selection in various scenarios. Recent advances in deep learning and network-based approaches are also explored, highlighting their potential to harmonize diverse biological information layers. Additionally, we present a roadmap for the integration of multi-omics data in precision oncology, outlining the advantages, challenges and implementation difficulties. Hence this review offers a thorough overview of current literature, providing researchers with insights into machine learning techniques for patient stratification, particularly in precision oncology. Contact:  anirban@klyuniv.ac.in.

Treatment resistance in pancreatic and biliary tract cancer: molecular and clinical pharmacology perspectives

INTRODUCTION

Treatment resistance poses a significant obstacle in oncology, especially in biliary tract cancer (BTC) and pancreatic cancer (PC). Current therapeutic options include chemotherapy, targeted therapy, and immunotherapy. Resistance to these treatments may arise due to diverse molecular mechanisms, such as genetic and epigenetic modifications, altered drug metabolism and efflux, and changes in the tumor microenvironment. Identifying and overcoming these mechanisms is a major focus of research: strategies being explored include combination therapies, modulation of the tumor microenvironment, and personalized approaches.

AREAS COVERED

We provide a current overview and discussion of the most relevant mechanisms of resistance to chemotherapy, target therapy, and immunotherapy in both BTC and PC. Furthermore, we compare the different strategies that are being implemented to overcome these obstacles.

EXPERT OPINION

So far there is no unified theory on drug resistance and progress is limited. To overcome this issue, individualized patient approaches, possibly through liquid biopsies or single-cell transcriptome studies, are suggested, along with the potential use of artificial intelligence, to guide effective treatment strategies. Furthermore, we provide insights into what we consider the most promising areas of research, and we speculate on the future of managing treatment resistance to improve patient outcomes.

Artificial intelligence in cancer diagnosis and therapy: Current status and future perspective

Artificial intelligence (AI) in healthcare plays a pivotal role in combating many fatal diseases, such as skin, breast, and lung cancer. AI is an advanced form of technology that uses mathematical-based algorithmic principles similar to those of the human mind for cognizing complex challenges of the healthcare unit. Cancer is a lethal disease with many etiologies, including numerous genetic and epigenetic mutations. Cancer being a multifactorial disease is difficult to be diagnosed at an early stage. Therefore, genetic variations and other leading factors could be identified in due time through AI and machine learning (ML). AI is the synergetic approach for mining the drug targets, their mechanism of action, and drug-organism interaction from massive raw data. This synergetic approach is also facing several challenges in data mining but computational algorithms from different scientific communities for multi-target drug discovery are highly helpful to overcome the bottlenecks in AI for drug-target discovery. AI and ML could be the epicenter in the medical world for the diagnosis, treatment, and evaluation of almost any disease in the near future. In this comprehensive review, we explore the immense potential of AI and ML when integrated with the biological sciences, specifically in the context of cancer research. Our goal is to illuminate the many ways in which AI and ML are being applied to the study of cancer, from diagnosis to individualized treatment. We highlight the prospective role of AI in supporting oncologists and other medical professionals in making informed decisions and improving patient outcomes by examining the intersection of AI and cancer control. Although AI-based medical therapies show great potential, many challenges must be overcome before they can be implemented in clinical practice. We critically assess the current hurdles and provide insights into the future directions of AI-driven approaches, aiming to pave the way for enhanced cancer interventions and improved patient care.

Machine learning integrations for development of a T-cell-tolerance derived signature to improve the clinical outcomes and precision treatment of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is characterized by high rates of recurrence and metastasis and poor prognosis. A recently discovered concept of T cell tolerance (TCT) has become an entirely new target of cancer immunotherapy. Unfortunately, the effect of TCT on the outcomes of HCC has not been explored. In this study, 7 public datasets and one external clinical cohort, including 1716 HCC patients were explored. Through WGCNA analysis and differential analysis, we explored the key TCT-related modulates. A total of 95 machine learning integrations across all validation cohorts were compared and the optimal method with the highest average C-index value was selected to construct the TCT derived signature (TCTS). In all independent clinical cohorts, TCTS showed accurate prediction of the prognosis, and was significantly correlated with clinical indicators and molecular features. Compared with 77 published gene signatures, the TCTS exhibited superior predictive performance. In the external clinical cohort, a novel nomogram (comprising TNM stage, Hepatitis B, Vascular invasion, Perineural invasion, AFP and TCTS) was constructed to test the clinical performance of TCTS. The results showed that the high TCTS scoring group showed dismal prognosis, improved sensitivity to oxaliplatin and good response to anti-PD-1/PD-L1 immunotherapy. Moreover, the low TCTS score group had few genomic alterations, low immune activation and low PD-1/PD-L1 expression levels. In conclusion, TCTS is an ideal biomarker for predicting the clinical outcomes and improving precision treatment of HCC.

Cancer risk stratification system and classification of gastritis: Perspectives

Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete. The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer, while mild to moderate atrophy has a low risk. The updated Kimura-Takemoto classification of atrophic gastritis considers five histological types of multifocal corpus atrophic gastritis according to stages C2 to O3. This method of morphological diagnosis of atrophic gastritis increases sensitivity by 2.4 times for severe atrophy compared to the updated Sydney system. This advantage should be considered when stratifying the high risk of gastric cancer. The updated Kimura-Takemoto classification of atrophic gastritis should be used as a reference standard (gold standard) in studies of morpho-functional relationships to identify serological markers of atrophic gastritis with evidence-based effectiveness. The use of artificial intelligence in the serological screening of atrophic gastritis makes it possible to screen a large number of the population. During serological screening of atrophic gastritis and risk stratification of gastric cancer, it is advisable to use the Kyoto classification of gastritis with updated Kimura-Takemoto classification of atrophic gastritis.

Artificial intelligence assists precision medicine in cancer treatment

Cancer is a major medical problem worldwide. Due to its high heterogeneity, the use of the same drugs or surgical methods in patients with the same tumor may have different curative effects, leading to the need for more accurate treatment methods for tumors and personalized treatments for patients. The precise treatment of tumors is essential, which renders obtaining an in-depth understanding of the changes that tumors undergo urgent, including changes in their genes, proteins and cancer cell phenotypes, in order to develop targeted treatment strategies for patients. Artificial intelligence (AI) based on big data can extract the hidden patterns, important information, and corresponding knowledge behind the enormous amount of data. For example, the ML and deep learning of subsets of AI can be used to mine the deep-level information in genomics, transcriptomics, proteomics, radiomics, digital pathological images, and other data, which can make clinicians synthetically and comprehensively understand tumors. In addition, AI can find new biomarkers from data to assist tumor screening, detection, diagnosis, treatment and prognosis prediction, so as to providing the best treatment for individual patients and improving their clinical outcomes.

Applications of artificial intelligence multiomics in precision oncology

Cancer is the second leading worldwide disease that depends on oncogenic mutations and non-mutated genes for survival. Recent advancements in next-generation sequencing (NGS) have transformed the health care sector with big data and machine learning (ML) approaches. NGS data are able to detect the abnormalities and mutations in the oncogenes. These multi-omics analyses are used for risk prediction, early diagnosis, accurate prognosis, and identification of biomarkers in cancer patients. The availability of these cancer data and their analysis may provide insights into the biology of the disease, which can be used for the personalized treatment of cancer patients. Bioinformatics tools are delivering this promise by managing, integrating, and analyzing these complex datasets. The clinical outcomes of cancer patients are improved by the use of various innovative methods implicated particularly for diagnosis and therapeutics. ML-based artificial intelligence (AI) applications are solving these issues to a great extent. AI techniques are used to update the patients on a personalized basis about their treatment procedures, progress, recovery, therapies used, dietary changes in lifestyles patterns along with the survival summary of previously recovered cancer patients. In this way, the patients are becoming more aware of their diseases and the entire clinical treatment procedures. Though the technology has its own advantages and disadvantages, we hope that the day is not so far when AI techniques will provide personalized treatment to cancer patients tailored to their needs in much quicker ways.

Biomedical Application of Identified Biomarkers Gene Expression Based Early Diagnosis and Detection in Cervical Cancer with Modified Probabilistic Neural Network

Cervical squamous cell carcinoma (CSC) is expected to rise to become the fourth most prevalent cancer in women globally and to replace breast cancer as the top cause of death in women in the future years, according to the World Health Organization. According to the World Health Organization, developing countries are responsible for 86 percent of all cervical cancer cases globally in women aged 15 to 44 (WHO). Cancer mortality is associated with the largest amount of monotonous antecedent in low- and middle-income nations, while cancer mortality is associated with the least amount of monotonous antecedent in high-income countries. Cervical cancer is thought to be caused by aberrant proliferation of cells in the cervix that is capable of stealing or invading other human organs, according to current thinking. Cancer of the cerebral cell is the most prevalent kind of cancer in women. It is expected that cervical squamous cell carcinoma (CSC) will be the fourth most frequent cancer in the world and the main cause of death in women by the year 2050. Despite the fact that technology has improved tremendously since then, this is still the case. When compared to high-income countries, low- and middle-income countries have the highest consistent antecedent for cancer mortality, according to the World Cancer Research Fund. Cancerous growths of cells in the cervix, such as cervical cancer, are caused by cells that have the ability to steal from or invade auxiliary organs of the body, as is the case with cervical cancer. Although technological advances have been made in recent years, gene expression profiling continues to be a prominent approach in the investigation of cervical cancer. Since then, researchers have had the opportunity to examine a gene coexpression network, which has evolved into an exceptionally comprehensive technique for microarray research. This has helped them to get a better understanding of the human genome. When a specific biological issue is addressed, gene coexpression networks retain a considerable percentage of their once vast component of physiognomy, which was previously immense. When comparing the properties of genes in a population, it is well known that feature selection may be used to choose genes that outperform the rest of the genes in the population. There are several benefits to feature selection, and this is only one of them. Typically used gene selection approaches have been shown to be insufficient in acquiring the best potential sequence of genes for training purposes, and as a result, the accuracy of the classifier has likely suffered as a result of this. Recently, a considerable number of scientists have advocated for the use of optimization approaches in the process of gene selection, and this trend is expected to continue. A metaheuristic algorithm may be used to choose a suitable subset of genes, according to the preceding assertion, which is also consistent with the metaheuristic approach. A Modified Probabilistic Neural Network differs from other networks in that the underlying gene expression associated with DEGs and standard data in a Modified Probabilistic Neural Network is not uniformly distributed as it is in other networks (MPN). As previously said, selecting the most relevant genes or repeating genes is a vital step in the prediction process. It was this technique that was used in the research of cervical cancer. Since then, researchers have had the opportunity to examine a gene coexpression network, which has evolved into an exceptionally comprehensive technique for microarray research. This has helped them to get a better understanding of the human genome. When a specific biological issue is addressed, gene coexpression networks are able to preserve a previously major section of the face that had been lost. When comparing the properties of genes in a population, it is well known that feature selection may be used to choose genes that outperform the rest of the genes in the population. There are several benefits to feature selection, and this is only one of them. Typically used gene selection approaches have been shown to be insufficient in acquiring the best potential sequence of genes for training purposes, and as a result, the accuracy of the classifier has likely suffered as a result of this. In the field of gene selection, several scholars have argued in favor of the employment of optimization approaches. A metaheuristic algorithm may be used to choose a suitable subset of genes, according to the preceding assertion, which is also consistent with the metaheuristic approach. It was discovered that Modified Probabilistic Neural Networks (MPNs) had a different distribution of gene expression linked with DEGs and normal data than other networks, which had not been previously seen. This was previously unknown. Following what has been said before, selecting the most appropriate or repeated genes is a critical task throughout the prediction process.

High resolution magic angle spinning MRS in prostate cancer

INTRODUCTION

Prostate cancer (PCa) is one of the leading causes of death among men worldwide. The current methods utilized to screen for prostate cancer may not have sufficient sensitivity in distinguishing aggressive from indolent diseases, which affect the quality of life of patients in the short and long term. The overdiagnosis of cases and overtreatment are prevalent due to the heterogeneity of the disease in terms of latent and progressive variants, as well as in the tissue types present in biopsy samples.

METHODS

The purpose of this review is to discuss the potential clinical benefits of incorporating high-resolution magic angle spinning (HRMAS) magnetic resonance spectroscopy (MRS) modalities to overcome the current challenges in the diagnosis, prognostication, and monitoring of PCa.

Artificial intelligence for the prevention and clinical management of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) currently represents the fifth most common malignancy and the third-leading cause of cancer-related death worldwide, with incidence and mortality rates that are increasing. Recently, artificial intelligence (AI) has emerged as a unique opportunity to improve the full spectrum of HCC clinical care, by improving HCC risk prediction, diagnosis, and prognostication. AI approaches include computational search algorithms, machine learning (ML) and deep learning (DL) models. ML consists of a computer running repeated iterations of models, in order to progressively improve performance of a specific task, such as classifying an outcome. DL models are a subtype of ML, based on neural network structures that are inspired by the neuroanatomy of the human brain. A growing body of recent data now apply DL models to diverse data sources - including electronic health record data, imaging modalities, histopathology and molecular biomarkers - to improve the accuracy of HCC risk prediction, detection and prediction of treatment response. Despite the promise of these early results, future research is still needed to standardise AI data, and to improve both the generalisability and interpretability of results. If such challenges can be overcome, AI has the potential to profoundly change the way in which care is provided to patients with or at risk of HCC.

Application of Artificial Intelligence in Discovery and Development of Anticancer and Antidiabetic Therapeutic Agents

Spectacular developments in molecular and cellular biology have led to important discoveries in cancer research. Despite cancer is one of the major causes of morbidity and mortality globally, diabetes is one of the most leading sources of group of disorders. Artificial intelligence (AI) has been considered the fourth industrial revolution machine. The most major hurdles in drug discovery and development are the time and expenditures required to sustain the drug research pipeline. Large amounts of data can be explored and generated by AI, which can then be converted into useful knowledge. Because of this, the world's largest drug companies have already begun to use AI in their drug development research. In the present era, AI has a huge amount of potential for the rapid discovery and development of new anticancer drugs. Clinical studies, electronic medical records, high-resolution medical imaging, and genomic assessments are just a few of the tools that could aid drug development. Large data sets are available to researchers in the pharmaceutical and medical fields, which can be analyzed by advanced AI systems. This review looked at how computational biology and AI technologies may be utilized in cancer precision drug development by combining knowledge of cancer medicines, drug resistance, and structural biology. This review also highlighted a realistic assessment of the potential for AI in understanding and managing diabetes.

An overview of artificial intelligence in oncology

Cancer is associated with significant morbimortality globally. Advances in screening, diagnosis, management and survivorship were substantial in the last decades, however, challenges in providing personalized and data-oriented care remain. Artificial intelligence (AI), a branch of computer science used for predictions and automation, has emerged as potential solution to improve the healthcare journey and to promote precision in healthcare. AI applications in oncology include, but are not limited to, optimization of cancer research, improvement of clinical practice (eg., prediction of the association of multiple parameters and outcomes - prognosis and response) and better understanding of tumor molecular biology. In this review, we examine the current state of AI in oncology, including fundamentals, current applications, limitations and future perspectives.

High-dimensional role of AI and machine learning in cancer research

The role of Artificial Intelligence and Machine Learning in cancer research offers several advantages, primarily scaling up the information processing and increasing the accuracy of the clinical decision-making. The key enabling tools currently in use in Precision, Digital and Translational Medicine, here named as 'Intelligent Systems' (IS), leverage unprecedented data volumes and aim to model their underlying heterogeneous influences and variables correlated with patients' outcomes. As functionality and performance of IS are associated with complex diagnosis and therapy decisions, a rich spectrum of patterns and features detected in high-dimensional data may be critical for inference purposes. Many challenges are also present in such discovery task. First, the generation of interpretable model results from a mix of structured and unstructured input information. Second, the design, and implementation of automated clinical decision processes for drawing disease trajectories and patient profiles. Ultimately, the clinical impacts depend on the data effectively subjected to steps such as harmonisation, integration, validation, etc. The aim of this work is to discuss the transformative value of IS applied to multimodal data acquired through various interrelated cancer domains (high-throughput genomics, experimental biology, medical image processing, radiomics, patient electronic records, etc.).

CHAIMELEON Project: Creation of a Pan-European Repository of Health Imaging Data for the Development of AI-Powered Cancer Management Tools

The CHAIMELEON project aims to set up a pan-European repository of health imaging data, tools and methodologies, with the ambition to set a standard and provide resources for future AI experimentation for cancer management. The project is a 4 year long, EU-funded project tackling some of the most ambitious research in the fields of biomedical imaging, artificial intelligence and cancer treatment, addressing the four types of cancer that currently have the highest prevalence worldwide: lung, breast, prostate and colorectal. To allow this, clinical partners and external collaborators will populate the repository with multimodality (MR, CT, PET/CT) imaging and related clinical data. Subsequently, AI developers will enable a multimodal analytical data engine facilitating the interpretation, extraction and exploitation of the information stored at the repository. The development and implementation of AI-powered pipelines will enable advancement towards automating data deidentification, curation, annotation, integrity securing and image harmonization. By the end of the project, the usability and performance of the repository as a tool fostering AI experimentation will be technically validated, including a validation subphase by world-class European AI developers, participating in Open Challenges to the AI Community. Upon successful validation of the repository, a set of selected AI tools will undergo early in-silico validation in observational clinical studies coordinated by leading experts in the partner hospitals. Tool performance will be assessed, including external independent validation on hallmark clinical decisions in response to some of the currently most important clinical end points in cancer. The project brings together a consortium of 18 European partners including hospitals, universities, R&D centers and private research companies, constituting an ecosystem of infrastructures, biobanks, AI/in-silico experimentation and cloud computing technologies in oncology.

Artificial Intelligence and Machine Learning in Cancer Research: A Systematic and Thematic Analysis of the Top 100 Cited Articles Indexed in Scopus Database

INTRODUCTION

Cancer is a major public health problem and a global leading cause of death where the screening, diagnosis, prediction, survival estimation, and treatment of cancer and control measures are still a major challenge. The rise of Artificial Intelligence (AI) and Machine Learning (ML) techniques and their applications in various fields have brought immense value in providing insights into advancement in support of cancer control.

METHODS

A systematic and thematic analysis was performed on the Scopus database to identify the top 100 cited articles in cancer research. Data were analyzed using RStudio and VOSviewer.Var1.6.6.

RESULTS

The top 100 articles in AI and ML in cancer received a 33 920 citation score with a range of 108 to 5758 times. Doi Kunio from the USA was the most cited author with total number of citations (TNC = 663). Out of 43 contributed countries, 30% of the top 100 cited articles originated from the USA, and 10% originated from China. Among the 57 peer-reviewed journals, the "Expert Systems with Application" published 8% of the total articles. The results were presented in highlight technological advancement through AI and ML via the widespread use of Artificial Neural Network (ANNs), Deep Learning or machine learning techniques, Mammography-based Model, Convolutional Neural Networks (SC-CNN), and text mining techniques in the prediction, diagnosis, and prevention of various types of cancers towards cancer control.

CONCLUSIONS

This bibliometric study provides detailed overview of the most cited empirical evidence in AI and ML adoption in cancer research that could efficiently help in designing future research. The innovations guarantee greater speed by using AI and ML in the detection and control of cancer to improve patient experience.

Machine Learning for Future Subtyping of the Tumor Microenvironment of Gastro-Esophageal Adenocarcinomas

Tumor progression involves an intricate interplay between malignant cells and their surrounding tumor microenvironment (TME) at specific sites. The TME is dynamic and is composed of stromal, parenchymal, and immune cells, which mediate cancer progression and therapy resistance. Evidence from preclinical and clinical studies revealed that TME targeting and reprogramming can be a promising approach to achieve anti-tumor effects in several cancers, including in GEA. Thus, it is of great interest to use modern technology to understand the relevant components of programming the TME. Here, we discuss the approach of machine learning, which recently gained increasing interest recently because of its ability to measure tumor parameters at the cellular level, reveal global features of relevance, and generate prognostic models. In this review, we discuss the relevant stromal composition of the TME in GEAs and discuss how they could be integrated. We also review the current progress in the application of machine learning in different medical disciplines that are relevant for the management and study of GEA.

Shifting Gears in Precision Oncology-Challenges and Opportunities of Integrative Data Analysis

For decades, research relating to modification of host immunity towards antitumor response activation has been ongoing, with the breakthrough discovery of immune-checkpoint blockers. Several biomarkers with potential predictive value have been reported in recent studies for these novel therapies. However, with the plethora of therapeutic options existing for a given cancer entity, modern oncology is now being confronted with multifactorial interpretation to devise “the best therapy” for the individual patient. Into the bargain come the multiverse guidelines for established and emerging diagnostic biomarkers, as well as the complex interplay between cancer cells and tumor microenvironment, provoking immense challenges in the therapy decision-making process. Through this review, we present various molecular diagnostic modalities and techniques, such as genomics, immunohistochemistry and quantitative image analysis, which have the potential of becoming powerful tools in the development of an optimal treatment regime when analogized with patient characteristics. We will summarize the underlying complexities of these methods and shed light upon the necessary considerations and requirements for data integration. It is our hope to provide compelling evidence to emphasize on the need for inclusion of integrative data analysis in modern cancer therapy, and thereupon paving a path towards precision medicine and better patient outcomes.

Machine learning in the prediction of cancer therapy

Resistance to therapy remains a major cause of cancer treatment failures, resulting in many cancer-related deaths. Resistance can occur at any time during the treatment, even at the beginning. The current treatment plan is dependent mainly on cancer subtypes and the presence of genetic mutations. Evidently, the presence of a genetic mutation does not always predict the therapeutic response and can vary for different cancer subtypes. Therefore, there is an unmet need for predictive models to match a cancer patient with a specific drug or drug combination. Recent advancements in predictive models using artificial intelligence have shown great promise in preclinical settings. However, despite massive improvements in computational power, building clinically useable models remains challenging due to a lack of clinically meaningful pharmacogenomic data. In this review, we provide an overview of recent advancements in therapeutic response prediction using machine learning, which is the most widely used branch of artificial intelligence. We describe the basics of machine learning algorithms, illustrate their use, and highlight the current challenges in therapy response prediction for clinical practice.

Clinical applications of artificial intelligence and machine learning in cancer diagnosis: looking into the future

Artificial intelligence (AI) is the use of mathematical algorithms to mimic human cognitive abilities and to address difficult healthcare challenges including complex biological abnormalities like cancer. The exponential growth of AI in the last decade is evidenced to be the potential platform for optimal decision-making by super-intelligence, where the human mind is limited to process huge data in a narrow time range. Cancer is a complex and multifaced disorder with thousands of genetic and epigenetic variations. AI-based algorithms hold great promise to pave the way to identify these genetic mutations and aberrant protein interactions at a very early stage. Modern biomedical research is also focused to bring AI technology to the clinics safely and ethically. AI-based assistance to pathologists and physicians could be the great leap forward towards prediction for disease risk, diagnosis, prognosis, and treatments. Clinical applications of AI and Machine Learning (ML) in cancer diagnosis and treatment are the future of medical guidance towards faster mapping of a new treatment for every individual. By using AI base system approach, researchers can collaborate in real-time and share knowledge digitally to potentially heal millions. In this review, we focused to present game-changing technology of the future in clinics, by connecting biology with Artificial Intelligence and explain how AI-based assistance help oncologist for precise treatment.

Recent advances in acoustic wave biosensors for the detection of disease-related biomarkers: A review

In the past several decades, acoustic wave biosensors, as an emerging kind of biosensors, have been developed and widely used for the detection of mass, viscosity, conductivity and density. Varieties of applications have been explored such as medical diagnosis, drug screening, environmental monitoring, food analysis and biochemical assay. Among them, the detection of disease-related biomarkers based on acoustic sensors has aroused great research interest all over the world. In this review, the classification and characteristics of acoustic wave biosensors are briefly introduced. Then, some classical studies and recent advances in disease-related biomarker detection utilizing these biosensors are summarized and detailed, respectively. Here, the disease-related biomarkers mainly include antigens, small molecular proteins, cancer cells, viruses and VOCs. Finally, challenges and future trends of these typical acoustic wave biosensors are discussed. Compared with other reviews of acoustic wave sensors, this review highlights the great potential of typical acoustic wave biosensors for early disease screening and diagnosis compared with widely-used medical imaging. Moreover, they are integrated with other technologies for the design of multi-analyte, multi-parameter and intelligent devices, collecting more comprehensive information from biomarkers. This review provides a new perspective on the applications and optimization of acoustic wave biosensors to develop more reliable platforms for disease-related biomarker detection and disease diagnosis.

Proteomic Profiling and Artificial Intelligence for Hepatocellular Carcinoma Translational Medicine

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver with high morbidity and mortality rates worldwide. Since 1963, when alpha-fetoprotein (AFP) was discovered as a first HCC serum biomarker, several other protein biomarkers have been identified and introduced into clinical practice. However, insufficient specificity and sensitivity of these biomarkers dictate the necessity of novel biomarker discovery. Remarkable advancements in integrated multiomics technologies for the identification of gene expression and protein or metabolite distribution patterns can facilitate rising to this challenge. Current multiomics technologies lead to the accumulation of a huge amount of data, which requires clustering and finding correlations between various datasets and developing predictive models for data filtering, pre-processing, and reducing dimensionality. Artificial intelligence (AI) technologies have an enormous potential to overcome accelerated data growth, complexity, and heterogeneity within and across data sources. Our review focuses on the recent progress in integrative proteomic profiling strategies and their usage in combination with machine learning and deep learning technologies for the discovery of novel biomarker candidates for HCC early diagnosis and prognosis. We discuss conventional and promising proteomic biomarkers of HCC such as AFP, lens culinaris agglutinin (LCA)-reactive L3 glycoform of AFP (AFP-L3), des-gamma-carboxyprothrombin (DCP), osteopontin (OPN), glypican-3 (GPC3), dickkopf-1 (DKK1), midkine (MDK), and squamous cell carcinoma antigen (SCCA) and highlight their functional significance including the involvement in cell signaling such as Wnt/β-catenin, PI3K/Akt, integrin αvβ3/NF-κB/HIF-1α, JAK/STAT3 and MAPK/ERK-mediated pathways dysregulated in HCC. We show that currently available computational platforms for big data analysis and AI technologies can both enhance proteomic profiling and improve imaging techniques to enhance the translational application of proteomics data into precision medicine.

Artificial Intelligence in the Intensive Care Unit

The diffusion of electronic health records collecting large amount of clinical, monitoring, and laboratory data produced by intensive care units (ICUs) is the natural terrain for the application of artificial intelligence (AI). AI has a broad definition, encompassing computer vision, natural language processing, and machine learning, with the latter being more commonly employed in the ICUs. Machine learning may be divided in supervised learning models (i.e., support vector machine [SVM] and random forest), unsupervised models (i.e., neural networks [NN]), and reinforcement learning. Supervised models require labeled data that is data mapped by human judgment against predefined categories. Unsupervised models, on the contrary, can be used to obtain reliable predictions even without labeled data. Machine learning models have been used in ICU to predict pathologies such as acute kidney injury, detect symptoms, including delirium, and propose therapeutic actions (vasopressors and fluids in sepsis). In the future, AI will be increasingly used in ICU, due to the increasing quality and quantity of available data. Accordingly, the ICU team will benefit from models with high accuracy that will be used for both research purposes and clinical practice. These models will be also the foundation of future decision support system (DSS), which will help the ICU team to visualize and analyze huge amounts of information. We plea for the creation of a standardization of a core group of data between different electronic health record systems, using a common dictionary for data labeling, which could greatly simplify sharing and merging of data from different centers.