_version_ 1866910853066915840
author Witowski, Jan
Zeng, Ken G.
Cappadona, Joseph
Elayoubi, Jailan
Choucair, Khalil
Chiru, Elena Diana
Chan, Nancy
Kang, Young-Joon
Howard, Frederick
Ostrovnaya, Irina
Fernandez-Granda, Carlos
Schnabel, Freya
Steinsnyder, Zoe
Ozerdem, Ugur
Liu, Kangning
Abdulsattar, Waleed
Zong, Yu
Daoud, Lina
Beydoun, Rafic
Saad, Anas
Thakore, Nitya
Sadic, Mohammad
Yeung, Frank
Liu, Elisa
Hill, Theodore
Swett, Benjamin
Rigau, Danielle
Clayburn, Andrew
Speirs, Valerie
Vetter, Marcus
Sojak, Lina
Soysal, Simone
Baumhoer, Daniel
Pan, Jia-Wern
Makmur, Haslina
Teo, Soo-Hwang
Pak, Linda Ma
Angel, Victor
Zilenaite-Petrulaitiene, Dovile
Laurinavicius, Arvydas
Klar, Natalie
Piening, Brian D.
Bifulco, Carlo
Jun, Sun-Young
Yi, Jae Pak
Lim, Su Hyun
Brufsky, Adam
Esteva, Francisco J.
Pusztai, Lajos
LeCun, Yann
Geras, Krzysztof J.
author_facet Witowski, Jan
Zeng, Ken G.
Cappadona, Joseph
Elayoubi, Jailan
Choucair, Khalil
Chiru, Elena Diana
Chan, Nancy
Kang, Young-Joon
Howard, Frederick
Ostrovnaya, Irina
Fernandez-Granda, Carlos
Schnabel, Freya
Steinsnyder, Zoe
Ozerdem, Ugur
Liu, Kangning
Abdulsattar, Waleed
Zong, Yu
Daoud, Lina
Beydoun, Rafic
Saad, Anas
Thakore, Nitya
Sadic, Mohammad
Yeung, Frank
Liu, Elisa
Hill, Theodore
Swett, Benjamin
Rigau, Danielle
Clayburn, Andrew
Speirs, Valerie
Vetter, Marcus
Sojak, Lina
Soysal, Simone
Baumhoer, Daniel
Pan, Jia-Wern
Makmur, Haslina
Teo, Soo-Hwang
Pak, Linda Ma
Angel, Victor
Zilenaite-Petrulaitiene, Dovile
Laurinavicius, Arvydas
Klar, Natalie
Piening, Brian D.
Bifulco, Carlo
Jun, Sun-Young
Yi, Jae Pak
Lim, Su Hyun
Brufsky, Adam
Esteva, Francisco J.
Pusztai, Lajos
LeCun, Yann
Geras, Krzysztof J.
contents Treatment selection in breast cancer is guided by molecular subtypes and clinical characteristics. However, current tools including genomic assays lack the accuracy required for optimal clinical decision-making. We developed a novel artificial intelligence (AI)-based approach that integrates digital pathology images with clinical data, providing a more robust and effective method for predicting the risk of cancer recurrence in breast cancer patients. Specifically, we utilized a vision transformer pan-cancer foundation model trained with self-supervised learning to extract features from digitized H&E-stained slides. These features were integrated with clinical data to form a multi-modal AI test predicting cancer recurrence and death. The test was developed and evaluated using data from a total of 8,161 female breast cancer patients across 15 cohorts originating from seven countries. Of these, 3,502 patients from five cohorts were used exclusively for evaluation, while the remaining patients were used for training. Our test accurately predicted our primary endpoint, disease-free interval, in the five evaluation cohorts (C-index: 0.71 [0.68-0.75], HR: 3.63 [3.02-4.37, p<0.001]). In a direct comparison (n=858), the AI test was more accurate than Oncotype DX, the standard-of-care 21-gene assay, achieving a C-index of 0.67 [0.61-0.74] versus 0.61 [0.49-0.73], respectively. Additionally, the AI test added independent prognostic information to Oncotype DX in a multivariate analysis (HR: 3.11 [1.91-5.09, p<0.001)]). The test demonstrated robust accuracy across major molecular breast cancer subtypes, including TNBC (C-index: 0.71 [0.62-0.81], HR: 3.81 [2.35-6.17, p=0.02]), where no diagnostic tools are currently recommended by clinical guidelines. These results suggest that our AI test improves upon the accuracy of existing prognostic tests, while being applicable to a wider range of patients.
format Preprint
id arxiv_https___arxiv_org_abs_2410_21256
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Multi-modal AI for comprehensive breast cancer prognostication
Witowski, Jan
Zeng, Ken G.
Cappadona, Joseph
Elayoubi, Jailan
Choucair, Khalil
Chiru, Elena Diana
Chan, Nancy
Kang, Young-Joon
Howard, Frederick
Ostrovnaya, Irina
Fernandez-Granda, Carlos
Schnabel, Freya
Steinsnyder, Zoe
Ozerdem, Ugur
Liu, Kangning
Abdulsattar, Waleed
Zong, Yu
Daoud, Lina
Beydoun, Rafic
Saad, Anas
Thakore, Nitya
Sadic, Mohammad
Yeung, Frank
Liu, Elisa
Hill, Theodore
Swett, Benjamin
Rigau, Danielle
Clayburn, Andrew
Speirs, Valerie
Vetter, Marcus
Sojak, Lina
Soysal, Simone
Baumhoer, Daniel
Pan, Jia-Wern
Makmur, Haslina
Teo, Soo-Hwang
Pak, Linda Ma
Angel, Victor
Zilenaite-Petrulaitiene, Dovile
Laurinavicius, Arvydas
Klar, Natalie
Piening, Brian D.
Bifulco, Carlo
Jun, Sun-Young
Yi, Jae Pak
Lim, Su Hyun
Brufsky, Adam
Esteva, Francisco J.
Pusztai, Lajos
LeCun, Yann
Geras, Krzysztof J.
Artificial Intelligence
Computer Vision and Pattern Recognition
Image and Video Processing
Treatment selection in breast cancer is guided by molecular subtypes and clinical characteristics. However, current tools including genomic assays lack the accuracy required for optimal clinical decision-making. We developed a novel artificial intelligence (AI)-based approach that integrates digital pathology images with clinical data, providing a more robust and effective method for predicting the risk of cancer recurrence in breast cancer patients. Specifically, we utilized a vision transformer pan-cancer foundation model trained with self-supervised learning to extract features from digitized H&E-stained slides. These features were integrated with clinical data to form a multi-modal AI test predicting cancer recurrence and death. The test was developed and evaluated using data from a total of 8,161 female breast cancer patients across 15 cohorts originating from seven countries. Of these, 3,502 patients from five cohorts were used exclusively for evaluation, while the remaining patients were used for training. Our test accurately predicted our primary endpoint, disease-free interval, in the five evaluation cohorts (C-index: 0.71 [0.68-0.75], HR: 3.63 [3.02-4.37, p<0.001]). In a direct comparison (n=858), the AI test was more accurate than Oncotype DX, the standard-of-care 21-gene assay, achieving a C-index of 0.67 [0.61-0.74] versus 0.61 [0.49-0.73], respectively. Additionally, the AI test added independent prognostic information to Oncotype DX in a multivariate analysis (HR: 3.11 [1.91-5.09, p<0.001)]). The test demonstrated robust accuracy across major molecular breast cancer subtypes, including TNBC (C-index: 0.71 [0.62-0.81], HR: 3.81 [2.35-6.17, p=0.02]), where no diagnostic tools are currently recommended by clinical guidelines. These results suggest that our AI test improves upon the accuracy of existing prognostic tests, while being applicable to a wider range of patients.
title Multi-modal AI for comprehensive breast cancer prognostication
topic Artificial Intelligence
Computer Vision and Pattern Recognition
Image and Video Processing
url https://arxiv.org/abs/2410.21256