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Main Authors: Lee, MunHwan, Chowdhury, Shaika, Li, Xiaodi, Rajaganapathy, Sivaraman, Klee, Eric W, Yang, Ping, Sio, Terence, Wang, Liewei, Cerhan, James, Zong, Nansu NA
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2512.20633
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author Lee, MunHwan
Chowdhury, Shaika
Li, Xiaodi
Rajaganapathy, Sivaraman
Klee, Eric W
Yang, Ping
Sio, Terence
Wang, Liewei
Cerhan, James
Zong, Nansu NA
author_facet Lee, MunHwan
Chowdhury, Shaika
Li, Xiaodi
Rajaganapathy, Sivaraman
Klee, Eric W
Yang, Ping
Sio, Terence
Wang, Liewei
Cerhan, James
Zong, Nansu NA
contents Accurate prediction of treatment outcomes in lung cancer remains challenging due to the sparsity, heterogeneity, and contextual overload of real-world electronic health data. Traditional models often fail to capture semantic information across multimodal streams, while large-scale fine-tuning approaches are impractical in clinical workflows. We introduce a framework that uses Large Language Models (LLMs) as Goal-oriented Knowledge Curators (GKC) to convert laboratory, genomic, and medication data into high-fidelity, task-aligned features. Unlike generic embeddings, GKC produces representations tailored to the prediction objective and operates as an offline preprocessing step that integrates naturally into hospital informatics pipelines. Using a lung cancer cohort (N=184), we benchmarked GKC against expert-engineered features, direct text embeddings, and an end-to-end transformer. Our approach achieved a mean AUROC of 0.803 (95% CI: 0.799-0.807) and outperformed all baselines. An ablation study further confirmed the complementary value of combining all three modalities. These results show that the quality of semantic representation is a key determinant of predictive accuracy in sparse clinical data settings. By reframing LLMs as knowledge curation engines rather than black-box predictors, this work demonstrates a scalable, interpretable, and workflow-compatible pathway for advancing AI-driven decision support in oncology.
format Preprint
id arxiv_https___arxiv_org_abs_2512_20633
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Enhancing Lung Cancer Treatment Outcome Prediction through Semantic Feature Engineering Using Large Language Models
Lee, MunHwan
Chowdhury, Shaika
Li, Xiaodi
Rajaganapathy, Sivaraman
Klee, Eric W
Yang, Ping
Sio, Terence
Wang, Liewei
Cerhan, James
Zong, Nansu NA
Machine Learning
Artificial Intelligence
Accurate prediction of treatment outcomes in lung cancer remains challenging due to the sparsity, heterogeneity, and contextual overload of real-world electronic health data. Traditional models often fail to capture semantic information across multimodal streams, while large-scale fine-tuning approaches are impractical in clinical workflows. We introduce a framework that uses Large Language Models (LLMs) as Goal-oriented Knowledge Curators (GKC) to convert laboratory, genomic, and medication data into high-fidelity, task-aligned features. Unlike generic embeddings, GKC produces representations tailored to the prediction objective and operates as an offline preprocessing step that integrates naturally into hospital informatics pipelines. Using a lung cancer cohort (N=184), we benchmarked GKC against expert-engineered features, direct text embeddings, and an end-to-end transformer. Our approach achieved a mean AUROC of 0.803 (95% CI: 0.799-0.807) and outperformed all baselines. An ablation study further confirmed the complementary value of combining all three modalities. These results show that the quality of semantic representation is a key determinant of predictive accuracy in sparse clinical data settings. By reframing LLMs as knowledge curation engines rather than black-box predictors, this work demonstrates a scalable, interpretable, and workflow-compatible pathway for advancing AI-driven decision support in oncology.
title Enhancing Lung Cancer Treatment Outcome Prediction through Semantic Feature Engineering Using Large Language Models
topic Machine Learning
Artificial Intelligence
url https://arxiv.org/abs/2512.20633