Deep learning-based predictive biomarker of pathological complete response to neoadjuvant chemotherapy from histological images in breast cancer

Journal of Translational Medicine

Ping He¹  Hong Bu²  Fengling Li²  Yani Wei²  Jie Chen³  Yongquan Yang³  Zhongxi Zheng³ 

[1] Department of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China;Department of Pathology, West China Hospital, Sichuan University, 610041, Chengdu, China;Institute of Clinical Pathology, West China Hospital, Sichuan University, 610041, Chengdu, China;Institute of Clinical Pathology, West China Hospital, Sichuan University, 610041, Chengdu, China;

关键词: Breast cancer;    Neoadjuvant chemotherapy;    Deep learning;    Digital pathology;   

DOI  :  10.1186/s12967-021-03020-z

来源: Springer

【 摘 要 】

BackgroundPathological complete response (pCR) is considered a surrogate endpoint for favorable survival in breast cancer patients treated with neoadjuvant chemotherapy (NAC). Predictive biomarkers of treatment response are crucial for guiding treatment decisions. With the hypothesis that histological information on tumor biopsy images could predict NAC response in breast cancer, we proposed a novel deep learning (DL)-based biomarker that predicts pCR from images of hematoxylin and eosin (H&E)-stained tissue and evaluated its predictive performance.MethodsIn total, 540 breast cancer patients receiving standard NAC were enrolled. Based on H&E-stained images, DL methods were employed to automatically identify tumor epithelium and predict pCR by scoring the identified tumor epithelium to produce a histopathological biomarker, the pCR-score. The predictive performance of the pCR-score was assessed and compared with that of conventional biomarkers including stromal tumor-infiltrating lymphocytes (sTILs) and subtype.ResultsThe pCR-score derived from H&E staining achieved an area under the curve (AUC) of 0.847 in predicting pCR directly, and achieved accuracy, F1 score, and AUC of 0.853, 0.503, and 0.822 processed by the logistic regression method, respectively, higher than either sTILs or subtype; a prediction model of pCR constructed by integrating sTILs, subtype and pCR-score yielded a mean AUC of 0.890, outperforming the baseline sTIL-subtype model by 0.051 (0.839, P  =  0.001).ConclusionThe DL-based pCR-score from histological images is predictive of pCR better than sTILs and subtype, and holds the great potentials for a more accurate stratification of patients for NAC.

【 授权许可】

CC BY