人工智能如何彻底改变多发性骨髓瘤的世界

Martha Romero, A. Mosquera Orgueira, Mateo Mejia Saldarriaga
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摘要

多发性骨髓瘤是全球发病率和死亡率第二高的血液系统恶性肿瘤。虽然多发性骨髓瘤被认为是一种不治之症,但随着人们对这种肿瘤认识的加深,新的治疗方法应运而生,从而延长了患者的寿命。通过临床试验、前瞻性登记和真实世界队列等不同的研究,已经产生了大量数据,并将实验室检测、流式细胞术、分子标记物、细胞遗传学、诊断图像和治疗方法纳入了常规临床实践。在这篇综述中,我们介绍了如何利用不同的人工智能模型来处理和分析这些数据,目的是提高准确性并转化为临床效益,大幅改善早期诊断和反应评估,加快分析速度,减少容易造成操作者偏差的劳动密集型流程,以及评估更多参数,从而提供更精确的信息。此外,我们还确定了人工智能是如何实现综合模型的开发的,这些模型可以预测对治疗的反应以及实现无法检测到的可测量残留疾病、无进展生存期和总生存期的概率,从而做出更好的临床决策,并有可能为个性化治疗提供信息,从而改善患者的预后。总之,人工智能有可能彻底改变多发性骨髓瘤的治疗,但有必要在前瞻性临床队列中进行验证,并开发出可用于日常临床实践的模型。
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How artificial intelligence revolutionizes the world of multiple myeloma
Multiple myeloma is the second most frequent hematologic malignancy worldwide with high morbidity and mortality. Although it is considered an incurable disease, the enhanced understanding of this neoplasm has led to new treatments, which have improved patients’ life expectancy. Large amounts of data have been generated through different studies in the settings of clinical trials, prospective registries, and real-world cohorts, which have incorporated laboratory tests, flow cytometry, molecular markers, cytogenetics, diagnostic images, and therapy into routine clinical practice. In this review, we described how these data can be processed and analyzed using different models of artificial intelligence, aiming to improve accuracy and translate into clinical benefit, allow a substantial improvement in early diagnosis and response evaluation, speed up analyses, reduce labor-intensive process prone to operator bias, and evaluate a greater number of parameters that provide more precise information. Furthermore, we identified how artificial intelligence has allowed the development of integrated models that predict response to therapy and the probability of achieving undetectable measurable residual disease, progression-free survival, and overall survival leading to better clinical decisions, with the potential to inform on personalized therapy, which could improve patients’ outcomes. Overall, artificial intelligence has the potential to revolutionize multiple myeloma care, being necessary to validate in prospective clinical cohorts and develop models to incorporate into routine daily clinical practice.
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