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29-10-2024 | Lung Cancer | Research Article

Predicting survival benefits of immune checkpoint inhibitor therapy in lung cancer patients: a machine learning approach using real-world data

Authors: Lingyun Pan, Li Mu, Haike Lei, Siwei Miao, Xiaogang Hu, Zongwei Tang, Wanyi Chen, Xiaoxiao Wang

Published in: International Journal of Clinical Pharmacy

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Abstract

Background

Due to the heterogeneity in the effectiveness of immunotherapy for lung cancer, identifying predictors is crucial.

Aim

This study aimed to develop a machine learning model to identify predictors of overall survival in lung cancer patients treated with immune checkpoint inhibitors (ICIs).

Method

A retrospective analysis was performed on data from 1314 lung cancer patients at the Chongqing University Cancer Hospital from September 2018 to September 2022. We used the random survival forest (RSF) model to identify survival-influencing factors, using backward elimination for variable selection. A Cox proportional hazards (CPH) model was constructed using the most significant predictors. We assessed model performance and generalizability using time-dependent receiver operating characteristics (ROC) and predictive error curves.

Results

The RSF model demonstrated better predictive accuracy than the CPH (IBS 0.17 vs. 0.17; C-index 0.91 vs. 0.68), with better discrimination and prediction performance. The influential variables identified included D-dimer, Karnofsky performance status, albumin, surgery, TNM stage, platelet count, and age. The RSF model, which incorporated these variables, achieved area under the curve (AUC) scores of 0.95, 0.94, and 0.98 for 1-, 3-, and 5-year survival predictions, respectively, in the training set. The validation set showed AUCs of 0.94, 0.90, and 0.95, respectively, exceeding the performance of the CPH model.

Conclusion

The study successfully developed a machine learning model that accurately predicted the survival benefits of ICI therapy in lung cancer patients, supporting clinical decision-making in lung cancer treatment.
Appendix
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Literature
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Metadata
Title
Predicting survival benefits of immune checkpoint inhibitor therapy in lung cancer patients: a machine learning approach using real-world data
Authors
Lingyun Pan
Li Mu
Haike Lei
Siwei Miao
Xiaogang Hu
Zongwei Tang
Wanyi Chen
Xiaoxiao Wang
Publication date
29-10-2024
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-024-01818-7

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