Application of GPT-4 foundation model for risk prediction and stratification in colorectal cancer.

Authors

null

Antonio Rueda-Lara

Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain

Antonio Rueda-Lara , David Viñal , Maria Alameda , Gema Martin-Montalvo , Jesus Peña-Lopez , Diego Jiménez-Bou , Iciar Ruiz-Gutierrez , Nuria Rodriguez Salas , Jaime Feliu

Organizations

Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain, Hospital La Paz, Madrid, Spain, Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain

Research Funding

No funding sources reported

Background: Deep Learning Language Models (LLMs) show significant potential in analyzing complex data, particularly in oncology, where they can predict and stratify patient risks, detect non-linear interactions, and weigh multiple variables. This study applies LLMs to stage II/III localized colon cancer patients to assess their effectiveness in identifying risk subgroups. Methods: In this retrospective study, we examined a cohort of stage II and III localized colorectal cancer patients diagnosed from September 2016 to December 2022 at La Paz University Hospital. Utilizing the GPT-4 API beta version, patients were stratified into high and low-risk groups for relapse based on various risk parameters outlined in the table. Notably, adjuvant treatment data was excluded from the input. The model was prompted with the question, "Given the following risk parameters for localized colorectal cancer {param}, guess whether the patient is in low risk or high risk for relapse," and the model provided dichotomic responses categorized as either 1 (high risk) or 0 (low risk). Results: Patient characteristics are depicted in the table. During a median follow-up of 23.68 months, 63 recurrence events and 73 deaths were observed. The GPT-4 model stratified patients into low (37.9%) and high-risk (62.1%) groups, with the survival curves showing a significant difference in outcomes between the groups. Low-risk patients had a relapse-free rate of 93% at 36 months vs 63% in the high-risk group. In univariate analysis, the high-risk variable had a hazard ratio (HR) of 4.26 (95% CI: 2.03-8.95; p < 0.005). When stratified by adjuvant treatment, no significant difference in relapse probability was observed for those receiving therapy. However, without adjuvant therapy, high-risk patients had an HR of 12.41 (95% CI: 3.72-41.97; p < 0.005) for relapse. Conclusions: GPT-4 demonstrated its potential in predicting oncology outcomes by accurately understanding colorectal cancer risk factors. To fully harness the benefits of LLMs in the future of oncology, they must be fine-tuned on extensive oncological datasets to improve patient risk stratification and treatment selection, ultimately leading to better patient outcomes.

Patient characteristics and data input to the GPT-4 model.

Patients390Percentage
Age
 Mean72
 Range35 - 95
Sex
 Male21355%
 Female17745%
Location
 Right19751%
 Left19349%
T
 121%
 2154%
 320953%
 416342%
Grade
 1133%
 233488%
 3328%
Lymph node
 >= 1234289%
 <= 124411%
Obstruction
 No34689%
 Yes4411%
Perforation
 No35892%
 Yes328%
LVI
 No20653%
 Yes18447%
PNI
 No30378%
 Yes8722%
Adyuvance
 Yes19751%
 No19249%
MMR
 MSS31681%
 MSI5514%
 Unknown195%
R
 036393%
 1277%
Pre-surgery CEA
 Mean7,4
 Range0,5 - 150

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Other

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 219)

DOI

10.1200/JCO.2024.42.3_suppl.219

Abstract #

219

Poster Bd #

N7

Abstract Disclosures