Development and validation of a machine learning model for predicting immune checkpoint inhibitor efficacy in advanced gastric cancer using dynamic changes in peripheral blood clinlabomics data: a retrospective multicenter cohort study.

IF 5.1 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Shulun Nie, Shuyi Song, Qian Xu, Xin Dai, Aina Liu, Meili Sun, Lei Cong, Jing Liang, Zimin Liu, Jing Lv, Zhen Li, Jinling Zhang, Fangli Cao, Linli Qu, Haiyan Liu, Lu Yue, Yi Zhai, Song Li, Lian Liu
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Abstract

Background: Immune checkpoint inhibitors (ICIs) play a pivotal role in the treatment of advanced gastric cancer (GC). However, the biomarkers used to predict ICI efficacy are limited due to their reliance on single or static tumor characteristics. This study aims to develop a machine learning (ML) model that incorporates dynamic changes in clinlabomics data to optimize the predictive accuracy of ICI efficacy.

Methods: This multicenter, retrospective study utilized nine ML to construct the model. Participants were further stratified into low-risk and high-risk groups based on the predicted efficacy of ICI. Kaplan-Meier survival curves and RNA-sequencing were used for differential analysis.

Results: This study enrolled 377 patients with advanced GC who underwent first-line ICI treatment across eleven hospitals between January 2018 and May 2023. Among them, 220 patients from Qilu Hospital of Shandong University were selected for the development model. The remaining ten hospitals contributed to two external test cohorts. Ten dynamic clinlabomics features were identified. The XGBoost demonstrated optimal performance in predicting ICI response, achieving an AUC of 0.863 in the training cohort, and 0.790-0.842 in the validation and two external cohorts. Notably, the model exhibited strong predictive capabilities compared to single point-in-time and previously proposed model. In the subgroup analysis, the low-risk subtype demonstrated a significantly improved prognosis and exhibited characteristics of "hot tumors". A web tool was generated: https://ici-therapeutic-efficacy-predictor-ztwwfwek2uckbmhxlnsayq.streamlit.app/ .

Conclusions: The dynamic clinlabomics model can effectively predict the ICI efficacy in advanced GC. The model was validated using multicenter data and provides new evidence to optimize treatment decisions.

利用外周血临床组学数据动态变化预测晚期胃癌免疫检查点抑制剂疗效的机器学习模型的开发和验证:一项回顾性多中心队列研究。
背景:免疫检查点抑制剂(ICIs)在晚期胃癌(GC)的治疗中发挥着关键作用。然而,用于预测ICI疗效的生物标志物由于依赖于单一或静态肿瘤特征而受到限制。本研究旨在开发一种机器学习(ML)模型,该模型结合临床组学数据的动态变化,以优化ICI疗效的预测准确性。方法:采用多中心、回顾性研究,采用9 ML构建模型。根据ICI的预测疗效,将参与者进一步分为低风险组和高风险组。Kaplan-Meier生存曲线和rna测序用于差异分析。结果:本研究纳入了2018年1月至2023年5月期间在11家医院接受一线ICI治疗的377例晚期GC患者。其中,选取山东大学齐鲁医院220例患者作为发展模型。其余10家医院提供了两个外部测试队列。确定了十个动态临床组学特征。XGBoost在预测ICI反应方面表现最佳,在训练队列中AUC为0.863,在验证和两个外部队列中AUC为0.790-0.842。值得注意的是,与单一时间点和先前提出的模型相比,该模型表现出较强的预测能力。在亚组分析中,低危亚型预后明显改善,表现出“热瘤”特征。生成了一个web工具:https://ici-therapeutic-efficacy-predictor-ztwwfwek2uckbmhxlnsayq.streamlit.app/。结论:动态临床组学模型可有效预测晚期胃癌患者ICI疗效。该模型使用多中心数据进行了验证,为优化治疗决策提供了新的证据。
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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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