Deep Learning to Estimate RECIST in Patients with NSCLC Treated with PD-1 Blockade.

Journal: Cancer discovery
Published Date:

Abstract

Real-world evidence (RWE), conclusions derived from analysis of patients not treated in clinical trials, is increasingly recognized as an opportunity for discovery, to reduce disparities, and to contribute to regulatory approval. Maximal value of RWE may be facilitated through machine-learning techniques to integrate and interrogate large and otherwise underutilized datasets. In cancer research, an ongoing challenge for RWE is the lack of reliable, reproducible, scalable assessment of treatment-specific outcomes. We hypothesized a deep-learning model could be trained to use radiology text reports to estimate gold-standard RECIST-defined outcomes. Using text reports from patients with non-small cell lung cancer treated with PD-1 blockade in a training cohort and two test cohorts, we developed a deep-learning model to accurately estimate best overall response and progression-free survival. Our model may be a tool to determine outcomes at scale, enabling analyses of large clinical databases. SIGNIFICANCE: We developed and validated a deep-learning model trained on radiology text reports to estimate gold-standard objective response categories used in clinical trial assessments. This tool may facilitate analysis of large real-world oncology datasets using objective outcome metrics determined more reliably and at greater scale than currently possible..

Authors

  • Kathryn C Arbour
    Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Anh Tuan Luu
    Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute for Technology, Cambridge, Massachusetts.
  • Jia Luo
    Business School, Chengdu University, Chengdu, China.
  • Hira Rizvi
    Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Andrew J Plodkowski
    Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Mustafa Sakhi
    Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
  • Kevin B Huang
    Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
  • Subba R Digumarthy
    Massachusetts General Hospital, Department of Radiolgoy, United States.
  • Michelle S Ginsberg
    Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Jeffrey Girshman
    Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Mark G Kris
    Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Gregory J Riely
    Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Adam Yala
    Department of Electrical Engineering and Computer Science, CSAIL, MIT, Cambridge, USA.
  • Justin F Gainor
    Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Regina Barzilay
    Computer Science and Artificial Intelligence Laboratory , Massachusetts Institute of Technology , 77 Massachusetts Avenue , Cambridge , MA 02139 , USA . Email: regina@csail.mit.edu.
  • Matthew D Hellmann
    Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York. hellmanm@mskcc.org regina@csail.mit.edu.