Artificial Intelligence-Powered Human Epidermal Growth Factor Receptor 2 and Tumor Microenvironment Analysis in Human Epidermal Growth Factor Receptor 2-Amplified Metastatic Colorectal Cancer: Exploratory Analysis of Phase II TRIUMPH Trial.

IF 5.3 2区 医学 Q1 ONCOLOGY JCO precision oncology Pub Date : 2025-01-01 Epub Date: 2025-01-17 DOI:10.1200/PO-24-00385
Mitsuho Imai, Yoshiaki Nakamura, Sangwon Shin, Wataru Okamoto, Takeshi Kato, Taito Esaki, Ken Kato, Yoshito Komatsu, Satoshi Yuki, Toshiki Masuishi, Tomohiro Nishina, Kentaro Sawada, Akihiro Sato, Takeshi Kuwata, Riu Yamashita, Takao Fujisawa, Hideaki Bando, Chan-Young Ock, Satoshi Fujii, Takayuki Yoshino
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Abstract

Purpose: Human epidermal growth factor receptor 2 (HER2)-targeted therapies have shown promise in treating HER2-amplified metastatic colorectal cancer (mCRC). Identifying optimal biomarkers for treatment decisions remains challenging. This study explores the potential of artificial intelligence (AI) in predicting treatment responses to trastuzumab plus pertuzumab (TP) in patients with HER2-amplified mCRC from the phase II TRIUMPH trial.

Materials and methods: AI-powered HER2 quantification continuous score (QCS) and tumor microenvironment (TME) analysis were applied to the prescreening cohort (n = 143) and the TRIUMPH cohort (n = 30). AI analyzers determined the proportions of tumor cells (TCs) with HER2 staining intensity and the densities of various cells in TME, examining their associations with clinical outcomes of TP.

Results: The AI-powered HER2 QCS for HER2 immunohistochemistry (IHC) achieved an accuracy of 86.7% against pathologist evaluations, with a 100% accuracy for HER2 IHC 3+ patients. Patients with ≥50% of TCs showing HER2 3+ staining intensity (AI-H3-high) exhibited significantly prolonged progression-free survival (PFS; median PFS, 4.4 v 1.4 months; hazard ratio [HR], 0.12 [95% CI, 0.04 to 0.38]) and overall survival (OS; median OS, 16.5 v 4.1 months; HR, 0.13 [95% CI, 0.05 to 0.38]) compared with the AI-H3-low (<50% group). Stratification among patients with AI-H3-high included TME-high (all lymphocyte, fibroblast, and macrophage densities in the cancer stroma above the median) and TME-low (anything below the median), showing a median PFS of 1.3 and 5.6 months for TME-high and TME-low respectively, with an HR of 0.04 (95% CI, 0.01 to 0.19) for AI-H3-high with TME-low compared with AI-H3-low.

Conclusion: AI-powered HER2 QCS and TME analysis demonstrated potential in enhancing treatment response predictions in patients with HER2-amplified mCRC undergoing TP therapy.

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人工智能驱动的人表皮生长因子受体2和肿瘤微环境分析在人表皮生长因子受体2扩增的转移性结直肠癌:实验性II期试验的分析。
目的:人表皮生长因子受体2 (HER2)靶向治疗在治疗HER2扩增的转移性结直肠癌(mCRC)中显示出希望。确定治疗决策的最佳生物标志物仍然具有挑战性。本研究探讨了人工智能(AI)在预测her2扩增mCRC患者对曲妥珠单抗加帕妥珠单抗(TP)治疗反应中的潜力。材料与方法:采用ai驱动的HER2定量连续评分(QCS)和肿瘤微环境(TME)分析方法对预筛选队列(n = 143)和TRIUMPH队列(n = 30)进行分析。AI分析仪测定了HER2染色强度的肿瘤细胞(TCs)比例和TME中各种细胞的密度,并研究了它们与TP临床结果的关系。结果:人工智能驱动的HER2免疫组化(IHC) QCS对病理学评估的准确率为86.7%,对HER2 IHC 3+患者的准确率为100%。≥50%的TCs显示HER2 3+染色强度(ai - h3高)的患者表现出显著延长的无进展生存期(PFS;中位PFS, 4.4 v 1.4个月;风险比[HR], 0.12 [95% CI, 0.04 ~ 0.38])和总生存期(OS;中位OS: 16.5 v 4.1个月;结论:ai驱动的HER2 QCS和TME分析显示,在接受TP治疗的HER2扩增的mCRC患者中,有可能提高治疗反应预测。
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