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Zhu L, Pan J, Mou W, Deng L, Zhu Y, Wang Y, Pareek G, Hyams E, Carneiro BA, Hadfield MJ, El-Deiry WS, Yang T, Tan T, Tong T, Ta N, Zhu Y, Gao Y, Lai Y, Cheng L, Chen R, Xue W. Harnessing artificial intelligence for prostate cancer management. Cell Rep Med 2024; 5:101506. [PMID: 38593808 PMCID: PMC11031422 DOI: 10.1016/j.xcrm.2024.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/05/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
Prostate cancer (PCa) is a common malignancy in males. The pathology review of PCa is crucial for clinical decision-making, but traditional pathology review is labor intensive and subjective to some extent. Digital pathology and whole-slide imaging enable the application of artificial intelligence (AI) in pathology. This review highlights the success of AI in detecting and grading PCa, predicting patient outcomes, and identifying molecular subtypes. We propose that AI-based methods could collaborate with pathologists to reduce workload and assist clinicians in formulating treatment recommendations. We also introduce the general process and challenges in developing AI pathology models for PCa. Importantly, we summarize publicly available datasets and open-source codes to facilitate the utilization of existing data and the comparison of the performance of different models to improve future studies.
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Affiliation(s)
- Lingxuan Zhu
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Changping Laboratory, Beijing, China
| | - Jiahua Pan
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Weiming Mou
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Longxin Deng
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Yinjie Zhu
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Yanqing Wang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Gyan Pareek
- Department of Surgery (Urology), Brown University Warren Alpert Medical School, Providence, RI, USA; Minimally Invasive Urology Institute, Providence, RI, USA
| | - Elias Hyams
- Department of Surgery (Urology), Brown University Warren Alpert Medical School, Providence, RI, USA; Minimally Invasive Urology Institute, Providence, RI, USA
| | - Benedito A Carneiro
- The Legorreta Cancer Center at Brown University, Lifespan Cancer Institute, Providence, RI, USA
| | - Matthew J Hadfield
- The Legorreta Cancer Center at Brown University, Lifespan Cancer Institute, Providence, RI, USA
| | - Wafik S El-Deiry
- The Legorreta Cancer Center at Brown University, Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Department of Pathology & Laboratory Medicine, The Warren Alpert Medical School of Brown University, The Joint Program in Cancer Biology, Brown University and Lifespan Health System, Division of Hematology/Oncology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Tao Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Tan
- Faculty of Applied Sciences, Macao Polytechnic University, Address: R. de Luís Gonzaga Gomes, Macao, China
| | - Tong Tong
- College of Physics and Information Engineering, Fuzhou University, Fujian 350108, China
| | - Na Ta
- Department of Pathology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Yan Zhu
- Department of Pathology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Yisha Gao
- Department of Pathology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Yancheng Lai
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Liang Cheng
- Department of Surgery (Urology), Brown University Warren Alpert Medical School, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, Lifespan Health, and the Legorreta Cancer Center at Brown University, Providence, RI, USA.
| | - Rui Chen
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
| | - Wei Xue
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
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Al-Tashi Q, Saad MB, Muneer A, Qureshi R, Mirjalili S, Sheshadri A, Le X, Vokes NI, Zhang J, Wu J. Machine Learning Models for the Identification of Prognostic and Predictive Cancer Biomarkers: A Systematic Review. Int J Mol Sci 2023; 24:7781. [PMID: 37175487 PMCID: PMC10178491 DOI: 10.3390/ijms24097781] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
The identification of biomarkers plays a crucial role in personalized medicine, both in the clinical and research settings. However, the contrast between predictive and prognostic biomarkers can be challenging due to the overlap between the two. A prognostic biomarker predicts the future outcome of cancer, regardless of treatment, and a predictive biomarker predicts the effectiveness of a therapeutic intervention. Misclassifying a prognostic biomarker as predictive (or vice versa) can have serious financial and personal consequences for patients. To address this issue, various statistical and machine learning approaches have been developed. The aim of this study is to present an in-depth analysis of recent advancements, trends, challenges, and future prospects in biomarker identification. A systematic search was conducted using PubMed to identify relevant studies published between 2017 and 2023. The selected studies were analyzed to better understand the concept of biomarker identification, evaluate machine learning methods, assess the level of research activity, and highlight the application of these methods in cancer research and treatment. Furthermore, existing obstacles and concerns are discussed to identify prospective research areas. We believe that this review will serve as a valuable resource for researchers, providing insights into the methods and approaches used in biomarker discovery and identifying future research opportunities.
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Affiliation(s)
- Qasem Al-Tashi
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maliazurina B. Saad
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Amgad Muneer
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rizwan Qureshi
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Seyedali Mirjalili
- Centre for Artificial Intelligence Research and Optimization, Torrens University Australia, Fortitude Valley, Brisbane, QLD 4006, Australia
- Yonsei Frontier Lab, Yonsei University, Seoul 03722, Republic of Korea
- University Research and Innovation Center, Obuda University, 1034 Budapest, Hungary
| | - Ajay Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Natalie I. Vokes
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jianjun Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jia Wu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Huss R, Raffler J, Märkl B. Artificial intelligence and digital biomarker in precision pathology guiding immune therapy selection and precision oncology. Cancer Rep (Hoboken) 2023:e1796. [PMID: 36813293 PMCID: PMC10363837 DOI: 10.1002/cnr2.1796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The currently available immunotherapies already changed the strategy how many cancers are treated from first to last line. Understanding even the most complex heterogeneity in tumor tissue and mapping the spatial cartography of the tumor immunity allows the best and optimized selection of immune modulating agents to (re-)activate the patient's immune system and direct it against the individual cancer in the most effective way. RECENT FINDINGS Primary cancer and metastases maintain a high degree of plasticity to escape any immune surveillance and continue to evolve depending on many intrinsic and extrinsic factors In the field of immune-oncology (IO) immune modulating agents are recognized as practice changing therapeutic modalities. Recent studies have shown that an optimal and lasting efficacy of IO therapeutics depends on the understanding of the spatial communication network and functional context of immune and cancer cells within the tumor microenvironment. Artificial intelligence (AI) provides an insight into the immune-cancer-network through the visualization of very complex tumor and immune interactions in cancer tissue specimens and allows the computer-assisted development and clinical validation of such digital biomarker. CONCLUSIONS The successful implementation of AI-supported digital biomarker solutions guides the clinical selection of effective immune therapeutics based on the retrieval and visualization of spatial and contextual information from cancer tissue images and standardized data. As such, computational pathology (CP) turns into "precision pathology" delivering individual therapy response prediction. Precision Pathology does not only include digital and computational solutions but also high levels of standardized processes in the routine histopathology workflow and the use of mathematical tools to support clinical and diagnostic decisions as the basic principle of a "precision oncology".
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Affiliation(s)
- Ralf Huss
- Medical Faculty University Augsburg, Augsburg, Germany
- Institute for Digital Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Johannes Raffler
- Institute for Digital Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Bruno Märkl
- Medical Faculty University Augsburg, Augsburg, Germany
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Budhwani KI, Patel ZH, Guenter RE, Charania AA. A hitchhiker's guide to cancer models. Trends Biotechnol 2022; 40:1361-1373. [PMID: 35534320 PMCID: PMC9588514 DOI: 10.1016/j.tibtech.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 01/21/2023]
Abstract
Cancer is a complex and uniquely personal disease. More than 1.7 million people in the United States are diagnosed with cancer every year. As the burden of cancer grows, so does the need for new, more effective therapeutics and for predictive tools to identify optimal, personalized treatment options for every patient. Cancer models that recapitulate various aspects of the disease are fundamental to making advances along the continuum of cancer treatment from benchside discoveries to bedside delivery. In this review, we use a thought experiment as a vehicle to arrive at four broad categories of cancer models and explore the strengths, weaknesses, opportunities, and threats for each category in advancing our understanding of the disease and improving treatment strategies.
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Affiliation(s)
- Karim I Budhwani
- CerFlux, Inc., Birmingham, AL, USA; Department of Radiation Oncology, Heersink School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; Department of Physics, Coe College, Cedar Rapids, IA, USA.
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5
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Fitzgerald J, Higgins D, Mazo Vargas C, Watson W, Mooney C, Rahman A, Aspell N, Connolly A, Aura Gonzalez C, Gallagher W. Future of biomarker evaluation in the realm of artificial intelligence algorithms: application in improved therapeutic stratification of patients with breast and prostate cancer. J Clin Pathol 2021; 74:429-434. [PMID: 34117103 DOI: 10.1136/jclinpath-2020-207351] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 12/24/2022]
Abstract
Clinical workflows in oncology depend on predictive and prognostic biomarkers. However, the growing number of complex biomarkers contributes to costly and delayed decision-making in routine oncology care and treatment. As cancer is expected to rank as the leading cause of death and the single most important barrier to increasing life expectancy in the 21st century, there is a major emphasis on precision medicine, particularly individualisation of treatment through better prediction of patient outcome. Over the past few years, both surgical and pathology specialties have suffered cutbacks and a low uptake of pathology specialists means a solution is required to enable high-throughput screening and personalised treatment in this area to alleviate bottlenecks. Digital imaging in pathology has undergone an exponential period of growth. Deep-learning (DL) platforms for hematoxylin and eosin (H&E) image analysis, with preliminary artificial intelligence (AI)-based grading capabilities of specimens, can evaluate image characteristics which may not be visually apparent to a pathologist and offer new possibilities for better modelling of disease appearance and possibly improve the prediction of disease stage and patient outcome. Although digital pathology and AI are still emerging areas, they are the critical components for advancing personalised medicine. Integration of transcriptomic analysis, clinical information and AI-based image analysis is yet an uncultivated field by which healthcare professionals can make improved treatment decisions in cancer. This short review describes the potential application of integrative AI in offering better detection, quantification, classification, prognosis and prediction of breast and prostate cancer and also highlights the utilisation of machine learning systems in biomarker evaluation.
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Affiliation(s)
- Jenny Fitzgerald
- Invent Building, Deciphex Ltd, Dublin City University, Dublin, Ireland
| | - Debra Higgins
- OncoAssure, Nova UCD, Belfield Innovation Park, Dublin, Ireland
| | - Claudia Mazo Vargas
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - William Watson
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine Mooney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Arman Rahman
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Niamh Aspell
- Invent Building, Deciphex Ltd, Dublin City University, Dublin, Ireland
| | - Amy Connolly
- Invent Building, Deciphex Ltd, Dublin City University, Dublin, Ireland
| | - Claudia Aura Gonzalez
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - William Gallagher
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
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6
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Artificial Intelligence and Its Impact on Urological Diseases and Management: A Comprehensive Review of the Literature. J Clin Med 2021; 10:jcm10091864. [PMID: 33925767 PMCID: PMC8123407 DOI: 10.3390/jcm10091864] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/04/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
Recent advances in artificial intelligence (AI) have certainly had a significant impact on the healthcare industry. In urology, AI has been widely adopted to deal with numerous disorders, irrespective of their severity, extending from conditions such as benign prostate hyperplasia to critical illnesses such as urothelial and prostate cancer. In this article, we aim to discuss how algorithms and techniques of artificial intelligence are equipped in the field of urology to detect, treat, and estimate the outcomes of urological diseases. Furthermore, we explain the advantages that come from using AI over any existing traditional methods.
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7
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Machine-Learning-Based Evaluation of Intratumoral Heterogeneity and Tumor-Stroma Interface for Clinical Guidance. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1724-1731. [PMID: 33895120 DOI: 10.1016/j.ajpath.2021.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/15/2021] [Indexed: 12/21/2022]
Abstract
Assessment of intratumoral heterogeneity and tumor-host interaction within the tumor microenvironment is becoming increasingly important for innovative cancer therapy decisions because of the unique information it can generate about the state of the disease. However, its assessment and quantification are limited by ambiguous definitions of the tumor-host interface and by human cognitive capacity in current pathology practice. Advances in machine learning and artificial intelligence have opened the field of digital pathology to novel tissue image analytics and feature extraction for generation of high-capacity computational disease management models. A particular benefit is expected from machine-learning applications that can perform extraction and quantification of subvisual features of both intratumoral heterogeneity and tumor microenvironment aspects. These methods generate information about cancer cell subpopulation heterogeneity, potential tumor-host interactions, and tissue microarchitecture, derived from morphologically resolved content using both explicit and implicit features. Several studies have achieved promising diagnostic, prognostic, and predictive artificial intelligence models that often outperform current clinical and pathology criteria. However, further effort is needed for clinical adoption of such methods through development of standardizable high-capacity workflows and proper validation studies.
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8
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Abstract
PURPOSE OF REVIEW Pathomics, the fusion of digitalized pathology and artificial intelligence, is currently changing the landscape of medical pathology and biologic disease classification. In this review, we give an overview of Pathomics and summarize its most relevant applications in urology. RECENT FINDINGS There is a steady rise in the number of studies employing Pathomics, and especially deep learning, in urology. In prostate cancer, several algorithms have been developed for the automatic differentiation between benign and malignant lesions and to differentiate Gleason scores. Furthermore, several applications have been developed for the automatic cancer cell detection in urine and for tumor assessment in renal cancer. Despite the explosion in research, Pathomics is not fully ready yet for widespread clinical application. SUMMARY In prostate cancer and other urologic pathologies, Pathomics is avidly being researched with commercial applications on the close horizon. Pathomics is set to improve the accuracy, speed, reliability, cost-effectiveness and generalizability of pathology, especially in uro-oncology.
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9
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Gavriel CG, Dimitriou N, Brieu N, Nearchou IP, Arandjelović O, Schmidt G, Harrison DJ, Caie PD. Assessment of Immunological Features in Muscle-Invasive Bladder Cancer Prognosis Using Ensemble Learning. Cancers (Basel) 2021; 13:cancers13071624. [PMID: 33915698 PMCID: PMC8036815 DOI: 10.3390/cancers13071624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/03/2023] Open
Abstract
The clinical staging and prognosis of muscle-invasive bladder cancer (MIBC) routinely includes the assessment of patient tissue samples by a pathologist. Recent studies corroborate the importance of image analysis in identifying and quantifying immunological markers from tissue samples that can provide further insight into patient prognosis. In this paper, we apply multiplex immunofluorescence to MIBC tissue sections to capture whole-slide images and quantify potential prognostic markers related to lymphocytes, macrophages, tumour buds, and PD-L1. We propose a machine-learning-based approach for the prediction of 5 year prognosis with different combinations of image, clinical, and spatial features. An ensemble model comprising several functionally different models successfully stratifies MIBC patients into two risk groups with high statistical significance (p value < 1×10-5). Critical to improving MIBC survival rates, our method correctly classifies 71.4% of the patients who succumb to MIBC, which is significantly more than the 28.6% of the current clinical gold standard, the TNM staging system.
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Affiliation(s)
- Christos G. Gavriel
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
- Correspondence:
| | - Neofytos Dimitriou
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK; (N.D.); (O.A.)
| | - Nicolas Brieu
- Definiens GmbH, 80636 Munich, Germany; (N.B.); (G.S.)
| | - Ines P. Nearchou
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
| | - Ognjen Arandjelović
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK; (N.D.); (O.A.)
| | | | - David J. Harrison
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
- NHS Lothian, University Hospitals Division, Edinburgh EH16 4SA, UK
| | - Peter D. Caie
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
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Kolling ML, Furstenau LB, Sott MK, Rabaioli B, Ulmi PH, Bragazzi NL, Tedesco LPC. Data Mining in Healthcare: Applying Strategic Intelligence Techniques to Depict 25 Years of Research Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063099. [PMID: 33802880 PMCID: PMC8002654 DOI: 10.3390/ijerph18063099] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Abstract
In order to identify the strategic topics and the thematic evolution structure of data mining applied to healthcare, in this paper, a bibliometric performance and network analysis (BPNA) was conducted. For this purpose, 6138 articles were sourced from the Web of Science covering the period from 1995 to July 2020 and the SciMAT software was used. Our results present a strategic diagram composed of 19 themes, of which the 8 motor themes ('NEURAL-NETWORKS', 'CANCER', 'ELETRONIC-HEALTH-RECORDS', 'DIABETES-MELLITUS', 'ALZHEIMER'S-DISEASE', 'BREAST-CANCER', 'DEPRESSION', and 'RANDOM-FOREST') are depicted in a thematic network. An in-depth analysis was carried out in order to find hidden patterns and to provide a general perspective of the field. The thematic network structure is arranged thusly that its subjects are organized into two different areas, (i) practices and techniques related to data mining in healthcare, and (ii) health concepts and disease supported by data mining, embodying, respectively, the hotspots related to the data mining and medical scopes, hence demonstrating the field's evolution over time. Such results make it possible to form the basis for future research and facilitate decision-making by researchers and practitioners, institutions, and governments interested in data mining in healthcare.
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Affiliation(s)
- Maikel Luis Kolling
- Graduate Program of Industrial Systems and Processes, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (M.L.K.); (M.K.S.)
| | - Leonardo B. Furstenau
- Department of Industrial Engineering, Federal University of Rio Grande do Sul, Porto Alegre 90035-190, Brazil;
| | - Michele Kremer Sott
- Graduate Program of Industrial Systems and Processes, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (M.L.K.); (M.K.S.)
| | - Bruna Rabaioli
- Department of Medicine, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil;
| | - Pedro Henrique Ulmi
- Department of Computer Science, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil;
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (N.L.B.); (L.P.C.T.)
| | - Leonel Pablo Carvalho Tedesco
- Graduate Program of Industrial Systems and Processes, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (M.L.K.); (M.K.S.)
- Department of Computer Science, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil;
- Correspondence: (N.L.B.); (L.P.C.T.)
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11
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Cappuccini F, Bryant R, Pollock E, Carter L, Verrill C, Hollidge J, Poulton I, Baker M, Mitton C, Baines A, Meier A, Schmidt G, Harrop R, Protheroe A, MacPherson R, Kennish S, Morgan S, Vigano S, Romero PJ, Evans T, Catto J, Hamdy F, Hill AVS, Redchenko I. Safety and immunogenicity of novel 5T4 viral vectored vaccination regimens in early stage prostate cancer: a phase I clinical trial. J Immunother Cancer 2020; 8:e000928. [PMID: 32591433 PMCID: PMC7319775 DOI: 10.1136/jitc-2020-000928] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) has been under investigation as a target for antigen-specific immunotherapies in metastatic disease settings for the last two decades leading to a licensure of the first therapeutic cancer vaccine, Sipuleucel-T, in 2010. However, neither Sipuleucel-T nor other experimental PCa vaccines that emerged later induce strong T-cell immunity. METHODS In this first-in-man study, VANCE, we evaluated a novel vaccination platform based on two replication-deficient viruses, chimpanzee adenovirus (ChAd) and MVA (Modified Vaccinia Ankara), targeting the oncofetal self-antigen 5T4 in early stage PCa. Forty patients, either newly diagnosed with early-stage PCa and scheduled for radical prostatectomy or patients with stable disease on an active surveillance protocol, were recruited to the study to assess the vaccine safety and T-cell immunogenicity. Secondary and exploratory endpoints included immune infiltration into the prostate, prostate-specific antigen (PSA) change, and assessment of phenotype and functionality of antigen-specific T cells. RESULTS The vaccine had an excellent safety profile. Vaccination-induced 5T4-specific T-cell responses were measured in blood by ex vivo IFN-γ ELISpot and were detected in the majority of patients with a mean level in responders of 198 spot-forming cells per million peripheral blood mononuclear cells. Flow cytometry analysis demonstrated the presence of both CD8+ and CD4+ polyfunctional 5T4-specific T cells in the circulation. 5T4-reactive tumor-infiltrating lymphocytes were isolated from post-treatment prostate tissue. Some of the patients had a transient PSA rise 2-8 weeks following vaccination, possibly indicating an inflammatory response in the target organ. CONCLUSIONS An excellent safety profile and T-cell responses elicited in the circulation and also detected in the prostate gland support the evaluation of the ChAdOx1-MVA 5T4 vaccine in efficacy trials. It remains to be seen if this vaccination strategy generates immune responses of sufficient magnitude to mediate clinical efficacy and whether it can be effective in late-stage PCa settings, as a monotherapy in advanced disease or as part of multi-modality PCa therapy. To address these questions, the phase I/II trial, ADVANCE, is currently recruiting patients with intermediate-risk PCa, and patients with advanced metastatic castration-resistant PCa, to receive this vaccine in combination with nivolumab. TRIAL REGISTRATION The trial was registered with the U.S. National Institutes of Health (NIH) Clinical Trials Registry (ClinicalTrials.gov identifier NCT02390063).
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Affiliation(s)
- Federica Cappuccini
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Richard Bryant
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Department of Urology, Churchill Hospital, Oxford, UK
| | - Emily Pollock
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Lucy Carter
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Clare Verrill
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University, Oxford, UK
| | - Julianne Hollidge
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
| | - Ian Poulton
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Megan Baker
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Celia Mitton
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Andrea Baines
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | | | | | | | - Andrew Protheroe
- Department of Oncology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, UK
| | | | - Steven Kennish
- Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Susan Morgan
- Department of Pathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Selena Vigano
- Oncology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Pedro J Romero
- Oncology, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - James Catto
- Academic Urology Unit, The University of Sheffield, Sheffield, UK
| | - Freddie Hamdy
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Department of Urology, Churchill Hospital, Oxford, UK
| | - Adrian V S Hill
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Irina Redchenko
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
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12
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Scaglioni D, Ellis M, Catapano F, Torelli S, Chambers D, Feng L, Sewry C, Morgan J, Muntoni F, Phadke R. A high-throughput digital script for multiplexed immunofluorescent analysis and quantification of sarcolemmal and sarcomeric proteins in muscular dystrophies. Acta Neuropathol Commun 2020; 8:53. [PMID: 32303261 PMCID: PMC7165405 DOI: 10.1186/s40478-020-00918-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/16/2020] [Indexed: 12/21/2022] Open
Abstract
The primary molecular endpoint for many Duchenne muscular dystrophy (DMD) clinical trials is the induction, or increase in production, of dystrophin protein in striated muscle. For accurate endpoint analysis, it is essential to have reliable, robust and objective quantification methodologies capable of detecting subtle changes in dystrophin expression. In this work, we present further development and optimisation of an automated, digital, high-throughput script for quantitative analysis of multiplexed immunofluorescent (IF) whole slide images (WSI) of dystrophin, dystrophin associated proteins (DAPs) and regenerating myofibres (fetal/developmental myosin-positive) in transverse sections of DMD, Becker muscular dystrophy (BMD) and control skeletal muscle biopsies. The script enables extensive automated assessment of myofibre morphometrics, protein quantification by fluorescence intensity and sarcolemmal circumference coverage, colocalisation data for dystrophin and DAPs and regeneration at the single myofibre and whole section level. Analysis revealed significant variation in dystrophin intensity, percentage coverage and amounts of DAPs between differing DMD and BMD samples. Accurate identification of dystrophin via a novel background subtraction method allowed differential assessment of DAP fluorescence intensity within dystrophin positive compared to dystrophin negative sarcolemma regions. This enabled surrogate quantification of molecular functionality of dystrophin in the assembly of the DAP complex. Overall, the digital script is capable of multiparametric and unbiased analysis of markers of myofibre regeneration and dystrophin in relation to key DAPs and enabled better characterisation of the heterogeneity in dystrophin expression patterns seen in BMD and DMD alongside the surrogate assessment of molecular functionality of dystrophin. Both these aspects will be of significant relevance to ongoing and future DMD and other muscular dystrophies clinical trials to help benchmark therapeutic efficacy.
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13
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Rasmusson A, Zilenaite D, Nestarenkaite A, Augulis R, Laurinaviciene A, Ostapenko V, Poskus T, Laurinavicius A. Immunogradient Indicators for Antitumor Response Assessment by Automated Tumor-Stroma Interface Zone Detection. THE AMERICAN JOURNAL OF PATHOLOGY 2020; 190:1309-1322. [PMID: 32194048 DOI: 10.1016/j.ajpath.2020.01.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/13/2020] [Accepted: 01/28/2020] [Indexed: 12/31/2022]
Abstract
The distribution of tumor-infiltrating lymphocytes (TILs) within the tumor microenvironment provides strong prognostic value, which is increasingly important with the arrival of new immunotherapy modalities. Both visual and image analysis-based assays are developed to assess the immune contexture of the tumors. We propose an automated method based on grid subsampling of microscopy image analysis data to extract the tumor-stroma interface zone (IZ) of controlled width. The IZ is a ranking of tissue areas by their distance to the tumor edge, which is determined by a set of explicit rules. TIL density profiles across the IZ are used to compute a set of novel immunogradient indicators that reflect TIL gradient towards the tumor. We applied this method on CD8 immunohistochemistry images of surgically excised hormone receptor-positive breast and colorectal cancers to predict overall patient survival. In both cohorts, the immunogradient indicators enabled strong and independent prognostic stratification, outperforming clinical and pathologic variables. Patients with breast cancer with low immunogradient levels had a prominent decrease in survival probability 5 years after surgery. Our study provides proof of concept that data-driven, automated, operator-independent IZ sampling enables spatial immune response measurement in the tumor-host interaction frontline for prediction of disease outcomes.
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Affiliation(s)
- Allan Rasmusson
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania.
| | - Dovile Zilenaite
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | - Ausrine Nestarenkaite
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Institute of Biosciences, Life Sciences Centre, Vilnius University, Vilnius, Lithuania
| | - Renaldas Augulis
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | - Aida Laurinaviciene
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | | | - Tomas Poskus
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Arvydas Laurinavicius
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania; Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
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14
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Huss R, Coupland SE. Software‐assisted decision support in digital histopathology. J Pathol 2020; 250:685-692. [DOI: 10.1002/path.5388] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/09/2020] [Accepted: 01/17/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Ralf Huss
- Institute of Pathology and Molecular Diagnostics University Hospital Augsburg Augsburg Germany
| | - Sarah E Coupland
- Department of Cellular and Molecular Pathology University of Liverpool Liverpool UK
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15
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Dong S, Wang Y, Liu Z, Zhang W, Yi K, Zhang X, Zhang X, Jiang C, Yang S, Wang F, Xiao X. Beehive-Inspired Macroporous SERS Probe for Cancer Detection through Capturing and Analyzing Exosomes in Plasma. ACS APPLIED MATERIALS & INTERFACES 2020; 12:5136-5146. [PMID: 31894690 DOI: 10.1021/acsami.9b21333] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The protein phosphorylation status of exosomes can regulate the activity and function of proteins related to cancer development, and it is highly possible to diagnose cancers through analyzing the protein phosphorylation status. However, monitoring the protein phosphorylation status with a simple and label-free method is still clinically challenging. Here, inspired by beehives, we developed an Au-coated TiO2 macroporous inverse opal (MIO) structure with an engineered "slow light effect" and thus with outstanding surface-enhanced Raman scattering (SERS) performance. The MIO structure can capture and analyze the exosomes from plasma of cancer patients without any labeling processes. It was found that the SERS intensity of exosomes at 1087 cm-1 arising from the P-O bond within the phosphoproteins can be used as a criterion for tumor liquid biopsies. The intensity of the 1087 cm-1 SERS peak from exosomes extracted from the plasma of cancer patients (prostate, lung, liver, and colon) is at least two times of that from healthy people. This indicates the simplicity and versatility of this method in cancer diagnostics. Our method has obvious advantages (noninvasive and time-saving) over currently clinically used tumor liquid biopsy techniques (such as western blot), which has great potentials to make vitro cancer diagnostics/monitoring as simple as diagnostics/monitoring of common diseases.
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Affiliation(s)
- Shilian Dong
- Department of Physics and Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory , Wuhan University , Wuhan 430072 , P. R. China
| | - Yuhui Wang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis , Zhongnan Hospital of Wuhan University , Wuhan 430071 , P. R. China
- Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , Henan 450072 , P.R. China
| | - Zhengqi Liu
- Institute of Optoelectronic Materials and Technology, College of Physics and Communication Electronics , Jiangxi Normal University , Nanchang 330022 , P. R. China
| | - Wuwen Zhang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis , Zhongnan Hospital of Wuhan University , Wuhan 430071 , P. R. China
| | - Kezhen Yi
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis , Zhongnan Hospital of Wuhan University , Wuhan 430071 , P. R. China
| | - Xingang Zhang
- Department of Physics and Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory , Wuhan University , Wuhan 430072 , P. R. China
| | - Xiaolei Zhang
- Department of Physics and Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory , Wuhan University , Wuhan 430072 , P. R. China
| | - Changzhong Jiang
- Department of Physics and Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory , Wuhan University , Wuhan 430072 , P. R. China
| | - Shikuan Yang
- School of Materials Science and Engineering , Zhejiang University , Hangzhou 310027 , P. R. China
| | - Fubing Wang
- Department of Clinical Laboratory Medicine and Center for Gene Diagnosis , Zhongnan Hospital of Wuhan University , Wuhan 430071 , P. R. China
| | - Xiangheng Xiao
- Department of Physics and Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory , Wuhan University , Wuhan 430072 , P. R. China
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16
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Chen J, Remulla D, Nguyen JH, Dua A, Liu Y, Dasgupta P, Hung AJ. Current status of artificial intelligence applications in urology and their potential to influence clinical practice. BJU Int 2019; 124:567-577. [PMID: 31219658 DOI: 10.1111/bju.14852] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome predictionin urologic diseases and evaluate its advantages over traditional models and methods. MATERIALS AND METHODS A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms "urology", "artificial intelligence", "machine learning" were included and categorized by the application of AI in urology. Review articles, editorial comments, articles with no full-text access, and nonurologic studies were excluded. RESULTS Initial search yielded 231 articles, but after excluding duplicates and following full-text review and examination of article references, only 111 articles were included in the final analysis. AI applications in urology include: utilizing radiomic imaging or ultrasonic echo data to improve or automate cancer detection or outcome prediction, utilizing digitized tissue specimen images to automate detection of cancer on pathology slides, and combining patient clinical data, biomarkers, or gene expression to assist disease diagnosis or outcome prediction. Some studies employed AI to plan brachytherapy and radiation treatments while others used video based or robotic automated performance metrics to objectively evaluate surgical skill. Compared to conventional statistical analysis, 71.8% of studies concluded that AI is superior in diagnosis and outcome prediction. CONCLUSION AI has been widely adopted in urology. Compared to conventional statistics AI approaches are more accurate in prediction and more explorative for analyzing large data cohorts. With an increasing library of patient data accessible to clinicians, AI may help facilitate evidence-based and individualized patient care.
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Affiliation(s)
- Jian Chen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Daphne Remulla
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Jessica H Nguyen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Aastha Dua
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Yan Liu
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Prokar Dasgupta
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Andrew J Hung
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
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17
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Specific immune cell and lymphatic vessel signatures identified by image analysis in renal cancer. Mod Pathol 2019; 32:1042-1052. [PMID: 30737470 DOI: 10.1038/s41379-019-0214-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/09/2019] [Accepted: 01/19/2019] [Indexed: 12/22/2022]
Abstract
Anti-angiogenic therapy and immune checkpoint inhibition are novel treatment strategies for patients with renal cell carcinoma. Various components and structures of the tumor microenvironment are potential predictive biomarkers and also attractive treatment targets. Macrophages, tumor infiltrating lymphocytes, vascular and lymphatic vessels represent an important part of the tumor immune environment, but their functional phenotypes and relevance for clinical outcome are yet ill defined. We applied Tissue Phenomics methods including image analysis for the standardized quantification of specific components and structures within the tumor microenvironment to profile tissue sections from 56 clear cell renal cell carcinoma patients. A characteristic composition and unique spatial relationship of CD68+ macrophages and tumor infiltrating lymphocytes correlated with overall survival. An inverse relationship was found between vascular (CD34) and lymphatic vessel (LYVE1) density. In addition, outcome was significantly better in patients with high blood vessel density in the tumors, whereas increased lymphatic vessel density in the tumors was associated with worse outcome. The Tissue Phenomics imaging analysis approach allowed visualization and simultaneous quantification of immune environment components, adding novel contextual information, and biological insights with potential applications in treatment response prediction.
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18
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Harder N, Schönmeyer R, Nekolla K, Meier A, Brieu N, Vanegas C, Madonna G, Capone M, Botti G, Ascierto PA, Schmidt G. Automatic discovery of image-based signatures for ipilimumab response prediction in malignant melanoma. Sci Rep 2019; 9:7449. [PMID: 31092853 PMCID: PMC6520405 DOI: 10.1038/s41598-019-43525-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/24/2019] [Indexed: 01/07/2023] Open
Abstract
In the context of precision medicine with immunotherapies there is an increasing need for companion diagnostic tests to identify potential therapy responders and avoid treatment coming along with severe adverse events for non-responders. Here, we present a retrospective case study to discover image-based signatures for developing a potential companion diagnostic test for ipilimumab (IPI) in malignant melanoma. Signature discovery is based on digital pathology and fully automatic quantitative image analysis using virtual multiplexing as well as machine learning and deep learning on whole-slide images. We systematically correlated the patient outcome data with potentially relevant local image features using a Tissue Phenomics approach with a sound cross validation procedure for reliable performance evaluation. Besides uni-variate models we also studied combinations of signatures in several multi-variate models. The most robust and best performing model was a decision tree model based on relative densities of CD8+ tumor infiltrating lymphocytes in the intra-tumoral infiltration region. Our results are well in agreement with observations described in previously published studies regarding the predictive value of the immune contexture, and thus, provide predictive potential for future development of a companion diagnostic test.
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Affiliation(s)
| | | | | | | | | | | | - Gabriele Madonna
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy
| | - Mariaelena Capone
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Gerardo Botti
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Paolo A Ascierto
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
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19
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Brieu N, Gavriel CG, Nearchou IP, Harrison DJ, Schmidt G, Caie PD. Automated tumour budding quantification by machine learning augments TNM staging in muscle-invasive bladder cancer prognosis. Sci Rep 2019; 9:5174. [PMID: 30914794 PMCID: PMC6435679 DOI: 10.1038/s41598-019-41595-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
Tumour budding has been described as an independent prognostic feature in several tumour types. We report for the first time the relationship between tumour budding and survival evaluated in patients with muscle invasive bladder cancer. A machine learning-based methodology was applied to accurately quantify tumour buds across immunofluorescence labelled whole slide images from 100 muscle invasive bladder cancer patients. Furthermore, tumour budding was found to be correlated to TNM (p = 0.00089) and pT (p = 0.0078) staging. A novel classification and regression tree model was constructed to stratify all stage II, III, and IV patients into three new staging criteria based on disease specific survival. For the stratification of non-metastatic patients into high or low risk of disease specific death, our decision tree model reported that tumour budding was the most significant feature (HR = 2.59, p = 0.0091), and no clinical feature was utilised to categorise these patients. Our findings demonstrate that tumour budding, quantified using automated image analysis provides prognostic value for muscle invasive bladder cancer patients and a better model fit than TNM staging.
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Affiliation(s)
- Nicolas Brieu
- Definiens AG, Bernhard-Wicki-Straße 5, 80636, München, Germany
| | - Christos G Gavriel
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - Ines P Nearchou
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - David J Harrison
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - Günter Schmidt
- Definiens AG, Bernhard-Wicki-Straße 5, 80636, München, Germany
| | - Peter D Caie
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK.
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20
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State-of-the-Art of Profiling Immune Contexture in the Era of Multiplexed Staining and Digital Analysis to Study Paraffin Tumor Tissues. Cancers (Basel) 2019; 11:cancers11020247. [PMID: 30791580 PMCID: PMC6406364 DOI: 10.3390/cancers11020247] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 02/07/2023] Open
Abstract
Multiplexed platforms for multiple epitope detection have emerged in the last years as very powerful tools to study tumor tissues. These revolutionary technologies provide important visual techniques for tumor examination in formalin-fixed paraffin-embedded specimens to improve the understanding of the tumor microenvironment, promote new treatment discoveries, aid in cancer prevention, as well as allowing translational studies to be carried out. The aim of this review is to highlight the more recent methodologies that use multiplexed staining to study simultaneous protein identification in formalin-fixed paraffin-embedded tumor tissues for immune profiling, clinical research, and potential translational analysis. New multiplexed methodologies, which permit the identification of several proteins at the same time in one single tissue section, have been developed in recent years with the ability to study different cell populations, cells by cells, and their spatial distribution in different tumor specimens including whole sections, core needle biopsies, and tissue microarrays. Multiplexed technologies associated with image analysis software can be performed with a high-quality throughput assay to study cancer specimens and are important tools for new discoveries. The different multiplexed technologies described in this review have shown their utility in the study of cancer tissues and their advantages for translational research studies and application in cancer prevention and treatments.
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21
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Schwen LO, Andersson E, Korski K, Weiss N, Haase S, Gaire F, Hahn HK, Homeyer A, Grimm O. Data-Driven Discovery of Immune Contexture Biomarkers. Front Oncol 2018; 8:627. [PMID: 30619761 PMCID: PMC6305402 DOI: 10.3389/fonc.2018.00627] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/03/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Features characterizing the immune contexture (IC) in the tumor microenvironment can be prognostic and predictive biomarkers. Identifying novel biomarkers can be challenging due to complex interactions between immune and tumor cells and the abundance of possible features. Methods: We describe an approach for the data-driven identification of IC biomarkers. For this purpose, we provide mathematical definitions of different feature classes, based on cell densities, cell-to-cell distances, and spatial heterogeneity thereof. Candidate biomarkers are ranked according to their potential for the predictive stratification of patients. Results: We evaluated the approach on a dataset of colorectal cancer patients with variable amounts of microsatellite instability. The most promising features that can be explored as biomarkers were based on cell-to-cell distances and spatial heterogeneity. Both the tumor and non-tumor compartments yielded features that were potentially predictive for therapy response and point in direction of further exploration. Conclusion: The data-driven approach simplifies the identification of promising IC biomarker candidates. Researchers can take guidance from the described approach to accelerate their biomarker research.
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Affiliation(s)
- Lars Ole Schwen
- Fraunhofer Institut für Bildgestützte Medizin, Bremen, Germany
| | - Emilia Andersson
- Pathology and Tissue Analytics, Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Konstanty Korski
- Pathology and Tissue Analytics, Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Nick Weiss
- Fraunhofer Institut für Bildgestützte Medizin, Lübeck, Germany
| | - Sabrina Haase
- Fraunhofer Institut für Bildgestützte Medizin, Bremen, Germany
| | - Fabien Gaire
- Pathology and Tissue Analytics, Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Horst K Hahn
- Fraunhofer Institut für Bildgestützte Medizin, Bremen, Germany
| | - André Homeyer
- Fraunhofer Institut für Bildgestützte Medizin, Bremen, Germany
| | - Oliver Grimm
- Pathology and Tissue Analytics, Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
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