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Original Articles
A Machine Learning Risk Prediction Model for Gastric Cancer with SHapley Additive exPlanations
Bomi Park, Chung Ho Kim, Jae Kwan Jun, Mina Suh, Kui Son Choi, Il Ju Choi, Hyun Jin Oh
Received August 29, 2024  Accepted December 15, 2024  Published online December 16, 2024  
DOI: https://doi.org/10.4143/crt.2024.843    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Gastric cancer (GC) prediction models hold potential for enhancing early detection by enabling the identification of high-risk individuals, facilitating personalized risk-based screening, and optimizing the allocation of healthcare resources.
Materials and Methods
In this study, we developed a machine learning-based GC prediction model utilizing data from the Korean National Health Insurance Service, encompassing 10,515,949 adults who had not been diagnosed with GC and underwent GC screening during 2013-2014, with a follow-up period of 5 years. The cohort was divided into training and test datasets at an 8:2 ratio, and class imbalance was mitigated through random oversampling.
Results
Among various models, logistic regression demonstrated the highest predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.708, which was consistent with the AUC obtained in external validation (0.669). Importantly, the outcomes were robust to missing data imputation and variable selection. The SHapley Additive exPlanations (SHAP) algorithm enhanced the explainability of the model, identifying advancing age, being male, Helicobacter pylori infection, current smoking, and a family history of GC as key predictors of elevated risk.
Conclusion
This predictive model could significantly contribute to the early identification of individuals at elevated risk for GC, thereby enabling the implementation of targeted preventive strategies. Furthermore, the integration of noninvasive and cost-effective predictors enhances the clinical utility of the model, supporting its potential application in routine healthcare settings.

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  • Development and validation of a prediction model for myelosuppression in lung cancer patients after platinum-based doublet chemotherapy: a multifactorial analysis approach
    Xueyan Li
    American Journal of Cancer Research.2025; 15(2): 470.     CrossRef
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  • 1 Crossref
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Machine Learning–Based Prognostic Gene Signature for Early Triple-Negative Breast Cancer
Ju Won Kim, Jonghyun Lee, Sung Hak Lee, Sangjeong Ahn, Kyong Hwa Park
Received September 26, 2024  Accepted November 18, 2024  Published online November 19, 2024  
DOI: https://doi.org/10.4143/crt.2024.937    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to develop a machine learning–based approach to identify prognostic gene signatures for early-stage triple-negative breast cancer (TNBC) using next-generation sequencing data from Asian populations.
Materials and Methods
We utilized next-generation sequencing data to analyze gene expression profiles and identify potential biomarkers. Our methodology involved integrating various machine learning techniques, including feature selection and model optimization. We employed logistic regression, Kaplan-Meier survival analysis, and receiver operating characteristic (ROC) curves to validate the identified gene signatures.
Results
We identified a gene signature significantly associated with relapse in TNBC patients. The predictive model demonstrated robustness and accuracy, with an area under the ROC curve of 0.9087, sensitivity of 0.8750, and specificity of 0.9231. The Kaplan-Meier survival analysis revealed a strong association between the gene signature and patient relapse, further validated by logistic regression analysis.
Conclusion
This study presents a novel machine learning-based prognostic tool for TNBC, offering significant implications for early detection and personalized treatment. The identified gene signature provides a promising approach for improving the management of TNBC, contributing to the advancement of precision oncology.
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Lung and Thoracic cancer
Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features
Harim Kim, Jonghoon Kim, Soohyun Hwang, You Jin Oh, Joong Hyun Ahn, Min-Ji Kim, Tae Hee Hong, Sung Goo Park, Joon Young Choi, Hong Kwan Kim, Jhingook Kim, Sumin Shin, Ho Yun Lee
Cancer Res Treat. 2025;57(1):57-69.   Published online June 26, 2024
DOI: https://doi.org/10.4143/crt.2024.251
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both 18F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.
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Gastrointestinal cancer
Development and Validation of Models to Predict Lymph Node Metastasis in Early Gastric Cancer Using Logistic Regression and Gradient Boosting Machine Methods
Hae Dong Lee, Kyung Han Nam, Cheol Min Shin, Hye Seung Lee, Young Hoon Chang, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee, Sang-Hoon Ahn, Hyung-Ho Kim
Cancer Res Treat. 2023;55(4):1240-1249.   Published online March 21, 2023
DOI: https://doi.org/10.4143/crt.2022.1330
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
To identify important features of lymph node metastasis (LNM) and develop a prediction model for early gastric cancer (EGC) using a gradient boosting machine (GBM) method.
Materials and Methods
The clinicopathologic data of 2556 patients with EGC who underwent gastrectomy were used as training set and the internal validation set (set 1) at a ratio of 8:2. Additionally, 548 patients with EGC who underwent endoscopic submucosal dissection (ESD) as the initial treatment were included in the external validation set (set 2). The GBM model was constructed, and its performance was compared with that of the Japanese guidelines.
Results
LNM was identified in 12.6% (321/2556) of the gastrectomy group (training set & set 1) and 4.3% (24/548) of the ESD group (set 2). In the GBM analysis, the top five features that most affected LNM were lymphovascular invasion, depth, differentiation, size, and location. The accuracy, sensitivity, specificity, and the area under the receiver operating characteristics of set 1 were 0.566, 0.922, 0.516, and 0.867, while those of set 2 were 0.810, 0.958, 0.803, and 0.944, respectively. When the sensitivity of GBM was adjusted to that of Japanese guidelines (beyond the expanded criteria in set 1 [0.922] and eCuraC-2 in set 2 [0.958]), the specificities of GBM in sets 1 and 2 were 0.516 (95% confidence interval, 0.502-0.523) and 0.803 (0.795-0.805), while those of the Japanese guidelines were 0.502 (0.488-0.509) and 0.788 (0.780-0.790), respectively.
Conclusion
The GBM model showed good performance comparable with the eCura system in predicting LNM risk in EGCs.

Citations

Citations to this article as recorded by  
  • Establishment of a machine learning model for predicting splenic hilar lymph node metastasis
    Kenichi Ishizu, Satoshi Takahashi, Nobuji Kouno, Ken Takasawa, Katsuji Takeda, Kota Matsui, Masashi Nishino, Tsutomu Hayashi, Yukinori Yamagata, Shigeyuki Matsui, Takaki Yoshikawa, Ryuji Hamamoto
    npj Digital Medicine.2025;[Epub]     CrossRef
  • The artificial intelligence revolution in gastric cancer management: clinical applications
    Runze Li, Jingfan Li, Yuman Wang, Xiaoyu Liu, Weichao Xu, Runxue Sun, Binqing Xue, Xinqian Zhang, Yikun Ai, Yanru Du, Jianming Jiang
    Cancer Cell International.2025;[Epub]     CrossRef
  • Machine learning models for prediction of lymph node metastasis in patients with gastric cancer: a Chinese single-centre study with external validation in an Asian American population
    Qian Li, Shangcheng Yan, Weiran Yang, Zhuan Du, Ming Cheng, Renwei Chen, Qiankun Shao, Yuan Tian, Mengchao Sheng, Wei Peng, Yongyou Wu
    BMJ Open.2025; 15(3): e098476.     CrossRef
  • Combining biomarkers to construct a novel predictive model for predicting preoperative lymph node metastasis in early gastric cancer
    Yujian He, Xiaoli Xie, Bingxue Yang, Xiaoxu Jin, Zhijie Feng
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Intratumoural and peritumoural CT-based radiomics for diagnosing lepidic-predominant adenocarcinoma in patients with pure ground-glass nodules: a machine learning approach
    Y. Zou, Q. Mao, Z. Zhao, X. Zhou, Y. Pan, Z. Zuo, W. Zhang
    Clinical Radiology.2024; 79(2): e211.     CrossRef
  • eCura and W-eCura: different scores, different populations, same goal
    Rui Morais, Diogo Libanio, João Santos-Antunes
    Gut.2024; 73(11): e29.     CrossRef
  • A machine learning model for predicting the lymph node metastasis of early gastric cancer not meeting the endoscopic curability criteria
    Minoru Kato, Yoshito Hayashi, Ryotaro Uema, Takashi Kanesaka, Shinjiro Yamaguchi, Akira Maekawa, Takuya Yamada, Masashi Yamamoto, Shinji Kitamura, Takuya Inoue, Shunsuke Yamamoto, Takashi Kizu, Risato Takeda, Hideharu Ogiyama, Katsumi Yamamoto, Kenji Aoi,
    Gastric Cancer.2024; 27(5): 1069.     CrossRef
  • The Application of Artificial Intelligence to Cancer Research: A Comprehensive Guide
    Amin Zadeh Shirazi, Morteza Tofighi, Alireza Gharavi, Guillermo A. Gomez
    Technology in Cancer Research & Treatment.2024;[Epub]     CrossRef
  • Computed Tomography-Based Radiomics Analysis of Different Machine Learning Approaches for Differentiating Pulmonary Sarcomatoid Carcinoma and Pulmonary Inflammatory Pseudotumor
    An-Lin Zhang, Yan-Mei Fu, Zhi-Yang He
    Iranian Journal of Radiology.2024;[Epub]     CrossRef
  • Screening of gastric cancer diagnostic biomarkers in the homologous recombination signaling pathway and assessment of their clinical and radiomic correlations
    Ahao Wu, Tengcheng Hu, Chao Lai, Qingwen Zeng, Lianghua Luo, Xufeng Shu, Pan Huang, Zhonghao Wang, Zongfeng Feng, Yanyan Zhu, Yi Cao, Zhengrong Li
    Cancer Medicine.2024;[Epub]     CrossRef
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  • 9 Web of Science
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Histopathologic and Molecular Biomarkers of PD-1/PD-L1 Inhibitor Treatment Response among Patients with Microsatellite Instability‒High Colon Cancer
Jaewon Hyung, Eun Jeong Cho, Jihun Kim, Jwa Hoon Kim, Jeong Eun Kim, Yong Sang Hong, Tae Won Kim, Chang Ohk Sung, Sun Young Kim
Cancer Res Treat. 2022;54(4):1175-1190.   Published online January 12, 2022
DOI: https://doi.org/10.4143/crt.2021.1133
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Recent clinical trials have reported response rates < 50% among patients treated with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors for microsatellite instability‒high (MSI-H) colorectal cancer (CRC), and factors predicting treatment response have not been fully identified. This study aimed to identify potential biomarkers of PD-1/PD-L1 inhibitor treatment response among patients with MSI-H CRC.
Materials and Methods
MSI-H CRC patients enrolled in three clinical trials of PD-1/PD-L1 blockade at Asan Medical Center (Seoul, Republic of Korea) were screened and classified into two groups according to treatment response. Their histopathologic features and expression of 730 immune-related genes from the NanoString platform were evaluated, and a machine learning–based classification model was built to predict treatment response among MSI-H CRCs patients.
Results
A total of 27 patients (15 responders, 12 non-responders) were included. A high degree of lymphocytic/neutrophilic infiltration and an expansile tumor border were associated with treatment response and prolonged progression-free survival (PFS), while mucinous/signet-ring cell carcinoma was associated with a lack of treatment response and short PFS. Gene expression profiles revealed that the interferon-γ response pathway was enriched in the responder group. Of the top eight differentially expressed immune-related genes, PRAME had the highest fold change in the responder group. Higher expression of PRAME was independently associated with better PFS along with histologic subtypes in the multivariate analysis. The classification model using these genes showed good performance for predicting treatment response.
Conclusion
We identified histologic and immune-related gene expression characteristics associated with treatment response in MSI-H CRC, which may contribute to optimal patient stratification.

Citations

Citations to this article as recorded by  
  • The Relationship of PRAME Expression with Clinicopathologic Parameters and Immunologic Markers in Melanomas: In Silico Analysis
    Yasemin Cakir, Banu Lebe
    Applied Immunohistochemistry & Molecular Morphology.2025; 33(2): 117.     CrossRef
  • Exploration of the regulatory mechanism of norcantharidin on sine oculis homeobox homolog 4 in colon cancer using transcriptome sequencing and bioinformatic
    Fanqin Zhang, Chao Wu, Jingyuan Zhang, Zhihong Huang, Antony Stalin, Yiyan Zhai, Shuqi Liu, Jiarui Wu
    Journal of Traditional Chinese Medical Sciences.2025; 12(2): 259.     CrossRef
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    Hang Yu, Qingquan Liu, Keting Wu, Shuang Tang
    Clinical and Experimental Medicine.2024;[Epub]     CrossRef
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    Loredana Farcaș, Diana Voskuil-Galoș
    Journal of Medical and Radiation Oncology.2024; 4(7): 1.     CrossRef
  • High serum IL-6 correlates with reduced clinical benefit of atezolizumab and bevacizumab in unresectable hepatocellular carcinoma
    Hannah Yang, Beodeul Kang, Yeonjung Ha, Sung Hwan Lee, Ilhwan Kim, Hyeyeong Kim, Won Suk Lee, Gwangil Kim, Sanghoon Jung, Sun Young Rha, Vincent E. Gaillard, Jaekyung Cheon, Chan Kim, Hong Jae Chon
    JHEP Reports.2023; 5(4): 100672.     CrossRef
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    Zhe Yang, Feiran Chen, Feng Wang, Xiubing Chen, Biaolin Zheng, Xiaomin Liao, Zhejun Deng, Xianxian Ruan, Jing Ning, Qing Li, Haixing Jiang, Shanyu Qin
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    Norah A. Alturki
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    Nian-Nian Zhong, Han-Qi Wang, Xin-Yue Huang, Zi-Zhan Li, Lei-Ming Cao, Fang-Yi Huo, Bing Liu, Lin-Lin Bu
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    Yuhan Yang, Yunuo Zhao, Xici Liu, Juan Huang
    Seminars in Cancer Biology.2022; 87: 137.     CrossRef
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  • 267 Download
  • 8 Web of Science
  • 11 Crossref
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Machine Learning Model for Predicting Postoperative Survival of Patients with Colorectal Cancer
Mohamed Hosny Osman, Reham Hosny Mohamed, Hossam Mohamed Sarhan, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Cancer Res Treat. 2022;54(2):517-524.   Published online June 15, 2021
DOI: https://doi.org/10.4143/crt.2021.206
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Machine learning (ML) is a strong candidate for making accurate predictions, as we can use large amount of data with powerful computational algorithms. We developed a ML based model to predict survival of patients with colorectal cancer (CRC) using data from two independent datasets.
Materials and Methods
A total of 364,316 and 1,572 CRC patients were included from the Surveillance, Epidemiology, and End Results (SEER) and a Korean dataset, respectively. As SEER combines data from 18 cancer registries, internal validation was done using 18-Fold-Cross-Validation then external validation was performed by testing the trained model on the Korean dataset. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), sensitivity and positive predictive values.
Results
Clinicopathological characteristics were significantly different between the two datasets and the SEER showed a significant lower 5-year survival rate compared to the Korean dataset (60.1% vs. 75.3%, p < 0.001). The ML-based model using the Light gradient boosting algorithm achieved a better performance in predicting 5-year-survival compared to American Joint Committee on Cancer stage (AUROC, 0.804 vs. 0.736; p < 0.001). The most important features which influenced model performance were age, number of examined lymph nodes, and tumor size. Sensitivity and positive predictive values of predicting 5-year-survival for classes including dead or alive were reported as 68.14%, 77.51% and 49.88%, 88.1% respectively in the validation set. Survival probability can be checked using the web-based survival predictor (http://colorectalcancer.pythonanywhere.com).
Conclusion
ML-based model achieved a much better performance compared to staging in individualized estimation of survival of patients with CRC.

Citations

Citations to this article as recorded by  
  • Development and validation of a biomarker-based prediction model for metastasis in patients with colorectal cancer: Application of machine learning algorithms
    Erfan Ayubi, Sajjad Farashi, Leili Tapak, Saeid Afshar
    Heliyon.2025; 11(1): e41443.     CrossRef
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    Alireza Jafarkhani, Behzad Imani, Soheila Saeedi, Amir Shams
    Health Science Reports.2025;[Epub]     CrossRef
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    Catarina Sousa Santos, Mário Amorim-Lopes
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    Ping Yang, Hang Qiu, Xulin Yang, Liya Wang, Xiaodong Wang
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  • The development and validation of automated machine learning models for predicting lymph node metastasis in Siewert type II T1 adenocarcinoma of the esophagogastric junction
    Chenghao Lu, Lu Liu, Minyue Yin, Jiaxi Lin, Shiqi Zhu, Jingwen Gao, Shuting Qu, Guoting Xu, Lihe Liu, Jinzhou Zhu, Chunfang Xu
    Frontiers in Medicine.2024;[Epub]     CrossRef
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    Erkan Kayikcioglu, Arif Hakan Onder, Burcu Bacak, Tekin Ahmet Serel
    Surgical Oncology.2024; 54: 102079.     CrossRef
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    Yonghong Wang, Ke Liu, Wanbin He, Jie Dan, Mingjie Zhu, Lei Chen, Wenjie Zhou, Ming Li, Jiangpeng Li
    Frontiers in Oncology.2024;[Epub]     CrossRef
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    Pradeep Kumar Yadalam, Prathiksha Vedhavalli Thirukkumaran, Prabhu Manickam Natarajan, Carlos M. Ardila
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    Lanni Zhou, Lizhu Ouyang, Baoliang Guo, Xiyi Huang, Shaomin Yang, Jialing Pan, Liwen Wang, Ming Chen, Fan Xie, Yunjing Li, Yongxing Du, Xinjie Chen, Qiugen Hu, Fusheng Ouyang
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Gastrointestinal Cancer
LASSO-Based Machine Learning Algorithm for Prediction of Lymph Node Metastasis in T1 Colorectal Cancer
Jeonghyun Kang, Yoon Jung Choi, Im-kyung Kim, Hye Sun Lee, Hogeun Kim, Seung Hyuk Baik, Nam Kyu Kim, Kang Young Lee
Cancer Res Treat. 2021;53(3):773-783.   Published online December 29, 2020
DOI: https://doi.org/10.4143/crt.2020.974
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The role of tumor-infiltrating lymphocytes (TILs) in predicting lymph node metastasis (LNM) in patients with T1 colorectal cancer (CRC) remains unclear. Furthermore, clinical utility of a machine learning–based approach has not been widely studied.
Materials and Methods
Immunohistochemistry for TILs against CD3, CD8, and forkhead box P3 in both center and invasive margin of the tumor were performed using surgically resected T1 CRC slides. Three hundred and sixteen patients were enrolled and categorized into training (n=221) and validation (n=95) sets via random sampling. Using clinicopathologic variables including TILs, the least absolute shrinkage and selection operator (LASSO) regression model was applied for variable selection and predictive signature building in the training set. The predictive accuracy of our model and the Japanese criteria were compared using area under the receiver operating characteristic (AUROC), net reclassification improvement (NRI)/integrated discrimination improvement (IDI), and decision curve analysis (DCA) in the validation set.
Results
LNM was detected in 29 (13.1%) and 12 (12.6%) patients in training and validation sets, respectively. Nine variables were selected and used to generate the LASSO model. Its performance was similar in training and validation sets (AUROC, 0.795 vs. 0.765; p=0.747). In the validation set, the LASSO model showed better outcomes in predicting LNM than Japanese criteria, as measured by AUROC (0.765 vs. 0.518, p=0.003) and NRI (0.447, p=0.039)/IDI (0.121, p=0.034). DCA showed positive net benefits in using our model.
Conclusion
Our LASSO model incorporating histopathologic parameters and TILs showed superior performance compared to conventional Japanese criteria in predicting LNM in patients with T1 CRC.

Citations

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    Jung Ho Bae
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    Nabanita Das, Bikash Sadhukhan, Chayan Ghosh, Avigyan Chowdhury, Satyajit Chakrabarti
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Prediction of Acquired Taxane Resistance Using a Personalized Pathway-Based Machine Learning Method
Young Rae Kim, Dongha Kim, Sung Young Kim
Cancer Res Treat. 2019;51(2):672-684.   Published online August 10, 2018
DOI: https://doi.org/10.4143/crt.2018.137
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study was conducted to develop and validate an individualized prediction model for automated detection of acquired taxane resistance (ATR).
Materials and Methods
Penalized regression, combinedwith an individualized pathway score algorithm,was applied to construct a predictive model using publically available genomic cohorts of ATR and intrinsic taxane resistance (ITR). To develop a model with enhanced generalizability, we merged multiple ATR studies then updated the learning parameter via robust cross-study validation.
Results
For internal cross-study validation, the ATR model produced a perfect performance with an overall area under the receiver operating curve (AUROC) of 1.000 with an area under the precision-recall curve (AUPRC) of 1.000, a Brier score of 0.007, a sensitivity and a specificity of 100%. The model showed an excellent performance on two independent blind ATR cohorts (overall AUROC of 0.940, AUPRC of 0.940, a Brier score of 0.127). When we applied our algorithm to two large-scale pharmacogenomic resources for ITR, the Cancer Genome Project (CGP) and the Cancer Cell Line Encyclopedia (CCLE), an overall ITR cross-study AUROC was 0.70, which is a far better accuracy than an almost random level reported by previous studies. Furthermore, this model had a high transferability on blind ATR cohorts with an AUROC of 0.69, suggesting that general predictive features may be at work across both ITR and ATR.
Conclusion
We successfully constructed a multi-study–derived personalized prediction model for ATR with excellent accuracy, generalizability, and transferability.

Citations

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