Multimodal machine learning analysis of more than 220,000 tumor profiles to diagnose molecular and morphological subtypes of cancer.

Authors

null

Jim Abraham

Caris Life Sciences, Phoenix, AZ

Jim Abraham , Sergey Klimov , Eghbal Amidi , Amy B. Heimberger , John Marshall , Elisabeth I. Heath , Joseph J. Drabick , Brian Rubin , Rouba Ali-Fehmi , David R. Braxton , George W. Sledge Jr., David Bryant , Curtis Johnston , Hassan Ghani , Matthew James Oberley , David Spetzler

Organizations

Caris Life Sciences, Phoenix, AZ, NORTHWESTERN UNIVERSITY, Chicago, IL, Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, Barbara Ann Karmanos Cancer Institute, Detroit, MI, Penn State Cancer Institute, Hershey, PA, Cleveland Clinic Brunswick Urgent Care, Cleveland, OH, Wayne State University, Karmanos Cancer Institute, Detroit, MI, Hoag Memor Hosp, Newport Beach, CA

Research Funding

No funding received
None.

Background: The diagnosis of a malignancy is typically informed by clinical presentation and tumor tissue features including cell morphology, immunohistochemistry, and molecular markers. Additionally, multi-omic approaches (Abraham 2021 Transl Oncol) and deep learning models using digital pathology (da Silva 2021 J Pathol) have augmented expert pathologists and led to improved diagnoses but are often not employed together on the same patient. The opportunity exists for a truly multimodal, multi-omic machine learning classifier that comprehensively assesses all aspects of a tumor from the molecular underpinnings to the morphological and histological phenotypic presentation to provide the most accurate diagnosis while at the same time providing predictive biomarker data from the same specimen. Methods: Whole transcriptome data from 220,246 tumor profiles, large panel and whole exome data from over 170,000 tumor profiles, and digital pathology features from over 50,000 tumors were used to construct a multi lineage classifier. The classifier was trained on 256 Oncotree classifications corresponding to established WHO diagnoses where a tumor of each class has been observed at least 30 times in our dataset. The dataset was split 50% for training and the other 50% for testing, UMAP was employed for dimensionality reduction, and ensemble models were used for making the final calls. The performance of the classifier was evaluated by comparing with traditional pathologist-directed diagnostic workup. Results: Tumor lineage classifiers predicted the correct classifications where the primary site was known with accuracies ranging between 97% and 100% when using the 32 highest level Oncotree categories corresponding to human tissues. Accuracy on the most granular Oncotree categories varied with many between 90 and 95%. When applied to Cancer of Unknown Primary (CUP) cases (n = 3589), an unequivocal Oncotree classification could be obtained over 90% of the time. Conclusions: Combining multi-omic and digital pathology information into a multimodal artificial intelligence platform can provide comprehensive information to pathologists to aid in diagnosis. This tool can be used to meet an unmet clinical need to define the lineage of CUP cases, which when coupled with biomarker data, will provide an opportunity to examine whether this information can be used to improve the outcomes of patient with CUP.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Track

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Sub Track

Molecular Diagnostics and Imaging

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 3078)

DOI

10.1200/JCO.2023.41.16_suppl.3078

Abstract #

3078

Poster Bd #

276

Abstract Disclosures

Similar Abstracts

Abstract

2023 ASCO Genitourinary Cancers Symposium

The CONFIDENT-P trial: Clinical implementation of artificial intelligence assistance in prostate cancer pathology.

First Author: Rachel Flach

First Author: Fei Tian Sr.

First Author: Tae-Yeong Kwak

First Author: Hei Ming Lai