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Bibliographic Details
Main Authors: Caragliano, Alice Natalina, Farina, Giulia, Aksu, Fatih, Caruso, Camillo Maria, Tacconi, Claudia, Greco, Carlo, Nibid, Lorenzo, Ippolito, Edy, Fiore, Michele, Perrone, Giuseppe, Ramella, Sara, Soda, Paolo, Guarrasi, Valerio
Format: Preprint
Published: 2026
Subjects:
Online Access:https://arxiv.org/abs/2603.15100
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Table of Contents:
  • Major pathological response (pR) following neoadjuvant therapy is a clinically meaningful endpoint in non-small cell lung cancer, strongly associated with improved survival. However, accurate preoperative prediction of pR remains challenging, particularly in real-world clinical settings characterized by limited data availability and incomplete clinical profiles. In this study, we propose a multimodal deep learning framework designed to address these constraints by integrating foundation model-based CT feature extraction with a missing-aware architecture for clinical variables. This approach enables robust learning from small cohorts while explicitly modeling missing clinical information, without relying on conventional imputation strategies. A weighted fusion mechanism is employed to leverage the complementary contributions of imaging and clinical modalities, yielding a multimodal model that consistently outperforms both unimodal imaging and clinical baselines. These findings underscore the added value of integrating heterogeneous data sources and highlight the potential of multimodal, missing-aware systems to support pR prediction under realistic clinical conditions.