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BackgroundMetastatic cancer remains one of the leading causes of cancer-related mortality worldwide. Yet, the prediction of survivability in this population remains limited by heterogeneous clinical presentations and high-dimensional molecular features. Advances in machine learning (ML) provide an opportunity to integrate diverse patient- and tumor-level factors into explainable predictive ML models. Leveraging large real-world datasets and modern ML techniques can enable improved risk stratification and precision oncology. ObjectiveThis study aimed to develop and interpret ML models for predicting overall survival in patients with metastatic cancer using the Memorial Sloan Kettering-Metastatic (MSK-MET) dataset and to identify key prognostic biomarkers through explainable artificial intelligence techniques. MethodsWe performed a retrospective analysis of the MSK-MET cohort, comprising 25,775 patients across 27 tumor types. After data cleaning and balancing, 20,338 patients were included. Overall survival was defined as deceased versus living at last follow-up. Five classifiers (extreme gradient boosting [XGBoost], logistic regression, random forest, decision tree, and naive Bayes) were trained using an 80/20 stratified split and optimized via grid search with 5-fold cross-validation. Model performance was assessed using accuracy, area under the curve (AUC), precision, recall, and F1-score. Model explainability was achieved using Shapley additive explanations (SHAP). Survival analyses included Kaplan-Meier estimates, Cox proportional hazards models, and an XGBoost-Cox model for time-to-event prediction. The positive predictive value and negative predictive value were calculated at the Youden index–optimal threshold. ResultsXGBoost achieved the highest performance (accuracy=0.74; AUC=0.82), outperforming other classifiers. In survival analyses, the XGBoost-Cox model with a concordance index (C-index) of 0.70 exceeded the traditional Cox model (C-index=0.66). SHAP analysis and Cox models consistently identified metastatic site count, tumor mutational burden, fraction of genome altered, and the presence of distant liver and bone metastases as among the strongest prognostic factors, a pattern that held at both the pan-cancer level and recurrently across cancer-specific models. At the cancer-specific level, performance varied; prostate cancer achieved the highest predictive accuracy (AUC=0.88), while pancreatic cancer was notably more challenging (AUC=0.68). Kaplan-Meier analyses demonstrated marked survival separation between patients with and without metastases (80-month survival: approximately 0.80 vs 0.30). At the Youden-optimal threshold, positive predictive value and negative predictive value were approximately 70% and 80%, respectively, supporting clinical use for risk stratification. ConclusionsExplainable ML models, particularly XGBoost combined with SHAP, can strongly predict survivability in metastatic cancers while highlighting clinically meaningful features. These findings support the use of ML-based tools for patient counseling, treatment planning, and integration into precision oncology workflows. Future work should include external validation on independent cohorts, integration with electronic health records via Fast Healthcare Interoperability Resources–based dashboards, and prospective clinician-in-the-loop evaluation to assess real-world use.
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Label free identification of different cancer cells using deep learning-based image analysis
Cancer diagnostics is an important field of cancer recovery and survival with many expensive procedures needed to administer the correct treatment. Machine Learning (ML) approaches can help with the diagnostic prediction from circulating tumor cells in liquid biopsy or from a primary tumor in solid biopsy. After predicting the metastatic potential from a deep learning model, doctors in a clinical setting can administer a safe and correct treatment for a specific patient. This paper investigates the use of deep convolutional neural networks for predicting a specific cancer cell line as a tool for label free identification. Specifically, deep learning strategies for weight initialization and performance metrics are described, with transfer learning and the accuracy metric utilized in this work. The equipment used for prediction involves brightfield microscopy without the use of chemical labels, advanced instruments, or time-consuming biological techniques, giving an advantage over current diagnostic methods. In the procedure, three different binary datasets of well-known cancer cell lines were collected, each having a difference in metastatic potential. Two different classification models were adopted (EfficientNetV2 and ResNet-50) with the analysis given for each stage in the ML architecture. The training results for each model and dataset are provided and systematically compared. We found that the test set accuracy showed favorable performance for both ML models with EfficientNetV2 accuracy reaching up to 99%. These test results allowed EfficientNetV2 to outperform ResNet-50 at an average percent increase of 3.5% for each dataset. The high accuracy obtained from the predictions demonstrates that the system can be retrained on a large-scale clinical dataset.
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- Award ID(s):
- 1935792
- PAR ID:
- 10588270
- Publisher / Repository:
- American Institute of Physics
- Date Published:
- Journal Name:
- APL Machine Learning
- Volume:
- 1
- Issue:
- 2
- ISSN:
- 2770-9019
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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