According to one study, the majority of melanoma-related fatalities occur in persons who were diagnosed with the most dangerous type of skin cancer at an early stage and later experienced a recurrence that was typically not detected until it had spread or metastasized.
Researchers at Massachusetts General Hospital (MGH) recently developed an artificial intelligence-based strategy to identify which patients are most likely to have a recurrence and hence benefit from intensive therapy. A research published in the journal npj Precision Oncology confirmed the approach.
Most patients with early-stage melanoma are treated with surgery to remove cancerous cells, but patients with more advanced cancer often receive immune checkpoint inhibitors, which effectively strengthen the immune response against tumor cells but also carry significant side effects.
“There is an urgent need to develop predictive tools to assist in the selection of high-risk patients for whom the benefits of immune checkpoint inhibitors would justify the high rate of morbid and potentially fatal immunologic adverse events observed with this therapeutic class,” says senior author Yevgeniy R. Semenov, MD, an investigator in the Department of Dermatology at MGH.
“Reliable prediction of melanoma recurrence can enable more precise treatment selection for immunotherapy, reduce progression to metastatic disease and improve melanoma survival while minimizing exposure to treatment toxicities.”
To help achieve this, Semenov and his colleagues assessed the effectiveness of algorithms based on machine learning, a branch of artificial intelligence, that used data from patient electronic health records to predict melanoma recurrence.
Specifically, the team collected 1,720 early-stage melanomas–1,172 from the Mass General Brigham healthcare system (MGB) and 548 from the Dana-Farber Cancer Institute (DFCI)–and extracted 36 clinical and pathologic features of these cancers from electronic health records to predict patients’ recurrence risk with machine learning algorithms. Algorithms were developed and validated with various MGB and DFCI patient sets, and tumor thickness and rate of cancer cell division were identified as the most predictive features.
“Our comprehensive risk prediction platform using novel machine learning approaches to determine the risk of early-stage melanoma recurrence reached high levels of classification and time to event prediction accuracy,” says Semenov. “Our results suggest that machine learning algorithms can extract predictive signals from clinicopathologic features for early-stage melanoma recurrence prediction, which will enable the identification of patients who may benefit from adjuvant immunotherapy.”
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