Ahmed, F. S. | bioRxiv Science

bioRxiv2022

Integrative deep learning analysis improves colon adenocarcinoma patient stratification at risk for mortality

Colorectal cancers are the fourth most commonly diagnosed cancer and the second leading cancer in number of deaths. Many clinical variables, pathological features, and genomic signatures are associated with patient risk, but reliable patient stratification in the clinic remains a challenging task. Here we assess how image, clinical, and genomic features can be combined to predict risk. We first observe that deep learning models based only on whole slide images (WSIs) from The Cancer Genome Atlas accurately separate high risk (OS<3years, N=38) from low risk (OS>5years, N=25) patients (AUC=0.81{+/-}0.08, 5year survival p-value=2.13e-25, 5year relative risk=5.09{+/-}0.05) though such models are less effective at predicting OS for moderate risk (3years<OS<5years, N=45) patients (5year survival p-value=0.5, 5year relative risk=1.32{+/-}0.09). However, we find that novel integrative models combining whole slide images, clinical variables, and mutation signatures can improve patient stratification for moderate risk patients (5year survival p-value=6.69e-30, 5year relative risk=5.32{+/-}0.07). Our integrative model combining image and clinical variables is also effective on an independent pathology dataset generated by our team (3year survival p-value=1.14e-09, 5year survival p-value=2.15e-05, 3year relative risk=3.25{+/-}0.06, 5year relative-risk=3.07{+/-}0.08). The integrative model substantially outperforms models using only images or only clinical variables, indicating beneficial cross-talk between the data types. Pathologist review of image-based heatmaps suggests that nuclear shape, nuclear size pleomorphism, intense cellularity, and abnormal structures are associated with high risk, while low risk regions tend to have more regular and small cells. The improved stratification of colorectal cancer patients from our computational methods can be beneficial for preemptive development of management and treatment plans for individual patients, as well as for informed enrollment of patients in clinical trials.

pathology↗

bioRxiv2021

Deep learning trained on H&E tumor ROIs predicts HER2 status and Trastuzumab treatment response in HER2+ breast cancer

The current standard of care for many patients with HER2-positive breast cancer is neoadjuvant chemotherapy in combination with anti-HER2 agents, based on HER2 amplification as detected by in situ hybridization (ISH) or protein immunohistochemistry (IHC). However, hematoxylin & eosin (H&E) tumor stains are more commonly available, and accurate prediction of HER2 status and anti-HER2 treatment response from H&E would reduce costs and increase the speed of treatment selection. Computational algorithms for H&E have been effective in predicting a variety of cancer features and clinical outcomes, including moderate success in predicting HER2 status. In this work, we present a novel convolutional neural network (CNN) approach able to predict HER2 status with increased accuracy over prior methods. We trained a CNN classifier on 188 H&E whole slide images (WSIs) manually annotated for tumor regions of interest (ROIs) by our pathology team. Our classifier achieved an area under the curve (AUC) of 0.90 in cross-validation of slide-level HER2 status and 0.81 on an independent TCGA test set. Within slides, we observed strong agreement between pathologist annotated ROIs and blinded computational predictions of tumor regions / HER2 status. Moreover, we trained our classifier on pre-treatment samples from 187 HER2+ patients that subsequently received trastuzumab therapy. Our classifier achieved an AUC of 0.80 in a five-fold cross validation. Our work provides an H&E-based algorithm that can predict HER2 status and trastuzumab response in breast cancer at an accuracy that is better than IHC and may benefit clinical evaluations.

bioinformatics↗