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用治疗前和治疗期间的预后生物标志物预测Atezolizumab治疗的晚期NSCLC患者的生存率
Sébastien Benzekry1, Mélanie Karlsen1, Célestin Bigarré1
1COMPutational Pharmacology and Clinical Oncology Department, Centre Inria de l'Université Côte d'Azur, Cancer Research Center of Marseille, Inserm UMR1068, CNRS UMR7258, Aix Marseille University UM105, Marseille, France.
Clinical pharmacology and therapeutics
|July 13, 2024
概括
一个新的动力学-机器学习 (kML) 模型整合了基线,瘤动力学和血液标志物,以改善接受免疫检查点抑制的非小细胞肺癌患者的生存预测.
科学领域:
- 在瘤学瘤学.
- 机器学习 机器学习
- 翻译医学是一种翻译医学.
背景情况:
- 目前用于癌症治疗的生存预测模型往往缺乏机器学习集成,仅依赖基线或瘤动态数据.
- 需要更准确和更动态的预测模型,这些模型将随时可用的治疗数据纳入其中.
研究的目的:
- 开发和验证一种新的动力学-机器学习 (kML) 模型,用于预测免疫检查点抑制 (ICI) 治疗非小细胞肺癌 (NSCLC) 患者的生存率.
- 评估kML模型预测治疗疗效的能力,并支持个性化医学和药物开发.
主要方法:
- 该kML模型整合了基线标记物,瘤动力学和四种简单的治疗血液标记物:白蛋白,C反应蛋白,乳酸脱酶和中性粒细胞.
- 该模型是使用三项II期试验 (533名患者) 的数据开发的,并在III期试验 (ICI和化疗手臂,377名和354名患者) 中得到验证.
主要成果:
- 与最先进的方法相比,kML模型显示出更高的性能,达到0.790的测试组C指数和78.7%的12个月生存精度.
- 它显著确定了长期幸存者 (危险比率为25.2,P < 0.0001).
- 关键的是,kML模型使用仅25周的研究数据准确预测了III期试验的成功.
结论:
- 将治疗中的血液标记物与预测机器学习相结合,为瘤学中的个性化医学提供了一种强大的方法.
- kML模型为改善存活预测和支持接受ICI治疗的NSCLC患者的临床决策提供了有价值的工具.
- 开发的模型和代码是公开的,以促进进一步的研究和应用.
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