Identifying actionable driver mutations in lung cancer using an efficient Asymmetric Transformer Decoder

Fuente: arXiv
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Auteurs principaux: Brattoli, Biagio, Shi, Jack, Park, Jongchan, Lee, Taebum, Yoo, Donggeun, Pereira, Sergio
Format: Preprint
Publié: 2025
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author Brattoli, Biagio
Shi, Jack
Park, Jongchan
Lee, Taebum
Yoo, Donggeun
Pereira, Sergio
author_facet Brattoli, Biagio
Shi, Jack
Park, Jongchan
Lee, Taebum
Yoo, Donggeun
Pereira, Sergio
contents Identifying actionable driver mutations in non-small cell lung cancer (NSCLC) can impact treatment decisions and significantly improve patient outcomes. Despite guideline recommendations, broader adoption of genetic testing remains challenging due to limited availability and lengthy turnaround times. Machine Learning (ML) methods for Computational Pathology (CPath) offer a potential solution; however, research often focuses on only one or two common mutations, limiting the clinical value of these tools and the pool of patients who can benefit from them. This study evaluates various Multiple Instance Learning (MIL) techniques to detect six key actionable NSCLC driver mutations: ALK, BRAF, EGFR, ERBB2, KRAS, and MET ex14. Additionally, we introduce an Asymmetric Transformer Decoder model that employs queries and key-values of varying dimensions to maintain a low query dimensionality. This approach efficiently extracts information from patch embeddings and minimizes overfitting risks, proving highly adaptable to the MIL setting. Moreover, we present a method to directly utilize tissue type in the model, addressing a typical MIL limitation where either all regions or only some specific regions are analyzed, neglecting biological relevance. Our method outperforms top MIL models by an average of 3%, and over 4% when predicting rare mutations such as ERBB2 and BRAF, moving ML-based tests closer to being practical alternatives to standard genetic testing.
format Preprint
id arxiv_https___arxiv_org_abs_2508_02431
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Identifying actionable driver mutations in lung cancer using an efficient Asymmetric Transformer Decoder
Brattoli, Biagio
Shi, Jack
Park, Jongchan
Lee, Taebum
Yoo, Donggeun
Pereira, Sergio
Image and Video Processing
Computer Vision and Pattern Recognition
Identifying actionable driver mutations in non-small cell lung cancer (NSCLC) can impact treatment decisions and significantly improve patient outcomes. Despite guideline recommendations, broader adoption of genetic testing remains challenging due to limited availability and lengthy turnaround times. Machine Learning (ML) methods for Computational Pathology (CPath) offer a potential solution; however, research often focuses on only one or two common mutations, limiting the clinical value of these tools and the pool of patients who can benefit from them. This study evaluates various Multiple Instance Learning (MIL) techniques to detect six key actionable NSCLC driver mutations: ALK, BRAF, EGFR, ERBB2, KRAS, and MET ex14. Additionally, we introduce an Asymmetric Transformer Decoder model that employs queries and key-values of varying dimensions to maintain a low query dimensionality. This approach efficiently extracts information from patch embeddings and minimizes overfitting risks, proving highly adaptable to the MIL setting. Moreover, we present a method to directly utilize tissue type in the model, addressing a typical MIL limitation where either all regions or only some specific regions are analyzed, neglecting biological relevance. Our method outperforms top MIL models by an average of 3%, and over 4% when predicting rare mutations such as ERBB2 and BRAF, moving ML-based tests closer to being practical alternatives to standard genetic testing.
title Identifying actionable driver mutations in lung cancer using an efficient Asymmetric Transformer Decoder
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2508.02431