A team of scientists led by Case Western Reserve University will use artificial intelligence (AI) to benefit certain head and neck cancer patients by reducing the intensity of treatments such as radiation therapy and chemotherapy. Has been identified.
Researchers used AI tools similar to those developed over the last decade at Case Western Reserve’s Computational Imaging and Personal Diagnostic Center (CCIPD).
The computer program has succeeded in identifying a subset of patients who may have benefited from significantly reduced radiation therapy.
The analysis is retroactive, meaning that the data from patients whose final results are already known was analyzed by computer, but researchers say the next step is to test its accuracy. Said there is a possibility. Clinical trials..
Their research has recently been National Cancer Center Journal..
This work was led by Anant Madabhushi, CCIPD Director, and Germán Corredor Prada, Professor of the Case School of Engineering, Donnell Institute, and a researcher at the CCIPD Lab.
Most other patients with HPV-induced cancer, along with patients whose cancer is unrelated to the virus, will benefit from aggressive treatment, but researchers have found an important group in their study. He said it became clear that he was receiving more aggressive treatment than needed to achieve favorable results.
Clinicians cannot easily make the distinction simply by looking at a tissue scan, the researchers said. Therefore, virtually all patients with these cancers, whether due to HPV or not, are treated with a full course of chemotherapy and radiation therapy.
“We have over-treated many patients with chemotherapy and radiation they don’t need because we had no way of finding out which patients would benefit from escalation,” Madabushi said. “We say we are doing that now, and one day doctors will adjust the way we care for people and standard high doses for everyone coming through the door. It’s not just about giving radiation. “
Reducing radiation in these patients may also help reduce the “toxicity of radiation therapy,” Madabushi said. This may reduce side effects such as dry mouth, dysphagia, and taste changes.
“National clinical trials are already underway and Radiation therapy “Intensity of chemotherapy and intensity of chemotherapy in patients with HPV-positive oropharyngeal cancer,” said Schlomokoifman, head and neck radiotherapy director and collaborator at Cleveland Clinic for head and neck and skin cancer. Said. This image classifier helps to better select patients for these new treatment paradigms. “
Cooperation between 10 institutions
Other researchers have already tested whether reducing the intensity of treatment benefits some patients, Colledor said. However, he said, this new study, when validated in human trials, could provide a tool for doctors to make better decisions about who should receive chemotherapy or radiation therapy.
“Chemotherapy and radiation therapy often have very strong side effects, so it may be possible to reduce the intensity of treatment for some people and give them a better quality of life,” Corredor said.
Almost 20 other scientists contributed, including 6 others from Case Western Reserve.
“We have been able to visually assess a patient’s tumor under a microscope for a very long time, but this technique can actually extract meaningful information from the morphology for prognosis and prediction. You can, “says James Lewis Jr., a professor of pathology and microbiology. Immunology of Vanderbilt University Medical Center and collaborators.
Scientists and doctors from the Cleveland and San Francisco Department of Veterans Affairs (VA) Medical Centers also participated. Baylor College of Medicine; Southern California Permanent Medical Group; University of Texas Southwestern Medical Center; University of California San Diego Health; University of Washington, St. Louis.
HPV, head and neck cancer
According to the World Health Organization, head and neck cancer is the sixth most common cancer in the world, with more than 500,000 cases and 300,000 deaths annually.
HPV is the most common sexually transmitted disease (STI), with approximately 43 million people infected in 2018, according to the Centers for Disease Control and Prevention. In addition, HPV accounts for about 75% of cases of oropharyngeal cancer in the United States.
Imaging biomarkers separated from routine digital pathology slides by a case Western reserve-led team reveal HPV-related cancer patients who receive or do not receive low-dose radiation instead of avoiding more severe treatment .. radiation Jeez.
According to Colledor, the system was able to accurately define “the spatial arrangement or structure of the lymphocytes that surround the cancer cells.” Lymphocytes are part of the immune system and are a type of white blood cell that attacks invading bacteria, viruses, and toxins.
This new study is also based on previous studies by CCIPD in the development of new imaging biomarkers for head and neck risk stratification and outcome prediction. cancer Published earlier this year Clinical research journal And other journals Oncology Frontier..
For more information:
Germán Corredoretal, an imaging biomarker of tumor-infiltrating lymphocytes for risk stratification of patients with HPV-related oropharyngeal cancer, JNCI: National Cancer Center Journal (2021). DOI: 10.1093 / jnci / djab215
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