Skip to main content
U.S. Department of Energy
Office of Scientific and Technical Information

Artificial intelligence to unlock real-world evidence in clinical oncology: A primer on recent advances

Journal Article · · Cancer Medicine
DOI:https://doi.org/10.1002/cam4.7253· OSTI ID:2396887
 [1];  [2];  [3];  [2];  [3];  [4];  [4];  [4];  [4];  [5];  [6];  [4];  [6];  [4];  [1];  [3];  [2];  [7]
  1. University of Michigan Medical School, Ann Arbor, MI (United States); Veterans Affairs (VA) Ann Arbor Health Care, MI (United States)
  2. Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)
  3. Brookhaven National Laboratory (BNL), Upton, NY (United States)
  4. University of Michigan Medical School, Ann Arbor, MI (United States)
  5. University of Michigan Medical School, Ann Arbor, MI (United States); University of Michigan, Ann Arbor, MI (United States)
  6. University of Michigan, Ann Arbor, MI (United States)
  7. University of Michigan Medical School, Ann Arbor, MI (United States); Veterans Affairs (VA) Ann Arbor Health Care, MI (United States); University of Michigan, Ann Arbor, MI (United States)
Purpose: Real world evidence is crucial to understanding the diffusion of new oncologic therapies, monitoring cancer outcomes, and detecting unexpected toxicities. In practice, real world evidence is challenging to collect rapidly and comprehensively, often requiring expensive and time-consuming manual case-finding and annotation of clinical text. In this Review, we summarise recent developments in the use of artificial intelligence to collect and analyze real world evidence in oncology. Methods: We performed a narrative review of the major current trends and recent literature in artificial intelligence applications in oncology. Results: Artificial intelligence (AI) approaches are increasingly used to efficiently phenotype patients and tumors at large scale. These tools also may provide novel biological insights and improve risk prediction through multimodal integration of radiographic, pathological, and genomic datasets. Custom language processing pipelines and large language models hold great promise for clinical prediction and phenotyping. Conclusions: Despite rapid advances, continued progress in computation, generalizability, interpretability, and reliability as well as prospective validation are needed to integrate AI approaches into routine clinical care and real-time monitoring of novel therapies.
Research Organization:
Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)
Sponsoring Organization:
USDOE Office of Science (SC)
Grant/Contract Number:
AC02-05CH11231
OSTI ID:
2396887
Journal Information:
Cancer Medicine, Journal Name: Cancer Medicine Journal Issue: 12 Vol. 13; ISSN 2045-7634
Publisher:
WileyCopyright Statement
Country of Publication:
United States
Language:
English

References (93)

Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer journal December 2017
Heterogeneity of Treatment Effect journal December 2021
Point-of-Care Digital Cytology With Artificial Intelligence for Cervical Cancer Screening in a Resource-Limited Setting journal March 2021
Assessment of the Role of Artificial Intelligence in the Association Between Time of Day and Colonoscopy Quality journal January 2023
Natural Language Processing in Oncology: A Review journal June 2016
Lung Cancer Screening With Low-Dose Computed Tomography in the United States—2010 to 2015 journal September 2017
Association of Machine Learning–Based Assessment of Tumor-Infiltrating Lymphocytes on Standard Histologic Images With Outcomes of Immunotherapy in Patients With NSCLC journal January 2023
Long-term Effect of Machine Learning–Triggered Behavioral Nudges on Serious Illness Conversations and End-of-Life Outcomes Among Patients With Cancer journal March 2023
Deep learning‐based auto segmentation using generative adversarial network on magnetic resonance images obtained for head and neck cancer patients journal March 2022
Automation and artificial intelligence in radiation therapy treatment planning journal October 2023
Integrating Natural Language Processing and Machine Learning Algorithms to Categorize Oncologic Response in Radiology Reports journal October 2017
Computer aided quantification of intratumoral stroma yields an independent prognosticator in rectal cancer journal March 2019
Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up journal December 2014
Comparison of the accuracy of human readers versus machine-learning algorithms for pigmented skin lesion classification: an open, web-based, international, diagnostic study journal July 2019
The false hope of current approaches to explainable artificial intelligence in health care journal November 2021
Dynamic prediction of renal survival among deeply phenotyped kidney transplant recipients using artificial intelligence: an observational, international, multicohort study journal December 2021
Development and validation of a radiopathomics model to predict pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicentre observational study journal January 2022
Validation of artificial intelligence prediction models for skin cancer diagnosis using dermoscopy images: the 2019 International Skin Imaging Collaboration Grand Challenge journal May 2022
Artificial intelligence and machine learning algorithms for early detection of skin cancer in community and primary care settings: a systematic review journal June 2022
Mining whole-lung information by artificial intelligence for predicting EGFR genotype and targeted therapy response in lung cancer: a multicohort study journal May 2022
Cost-effectiveness of artificial intelligence for screening colonoscopy: a modelling study journal June 2022
Spatially aware graph neural networks and cross-level molecular profile prediction in colon cancer histopathology: a retrospective multi-cohort study journal November 2022
Artificial intelligence for multimodal data integration in oncology journal October 2022
Dynamic Risk Profiling Using Serial Tumor Biomarkers for Personalized Outcome Prediction journal July 2019
Systematic outperformance of 112 dermatologists in multiclass skin cancer image classification by convolutional neural networks journal September 2019
Portable automatic text classification for adverse drug reaction detection via multi-corpus training journal February 2015
Machine Learning Methods to Extract Documentation of Breast Cancer Symptoms From Electronic Health Records journal June 2018
Dermatologist-level classification of skin cancer with deep neural networks journal January 2017
Digital pathology and artificial intelligence in translational medicine and clinical practice journal January 2022
Explainable machine-learning predictions for the prevention of hypoxaemia during surgery journal October 2018
Real-world evidence and regulatory drug approval journal February 2020
A clinically applicable approach to continuous prediction of future acute kidney injury journal July 2019
Evaluating eligibility criteria of oncology trials using real-world data and AI journal April 2021
Health system-scale language models are all-purpose prediction engines journal June 2023
Classification and mutation prediction from non–small cell lung cancer histopathology images using deep learning journal September 2018
Human–computer collaboration for skin cancer recognition journal June 2020
Federated learning for predicting histological response to neoadjuvant chemotherapy in triple-negative breast cancer journal January 2023
External validation of AI models in health should be replaced with recurring local validation journal October 2023
A deep database of medical abbreviations and acronyms for natural language processing journal June 2021
A comparative study of auto-contouring softwares in delineation of organs at risk in lung cancer and rectal cancer journal November 2021
A meta-analysis of Watson for Oncology in clinical application journal March 2021
Artificial intelligence-based radiomics for the prediction of nodal metastasis in early-stage lung cancer journal January 2023
Self-supervised attention-based deep learning for pan-cancer mutation prediction from histopathology journal March 2023
Prostate cancer therapy personalization via multi-modal deep learning on randomized phase III clinical trials journal June 2022
Multimodal data integration using machine learning improves risk stratification of high-grade serous ovarian cancer journal June 2022
Multimodal integration of radiology, pathology and genomics for prediction of response to PD-(L)1 blockade in patients with non-small cell lung cancer journal August 2022
Accurate and reproducible invasive breast cancer detection in whole-slide images: A Deep Learning approach for quantifying tumor extent journal April 2017
Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study1☆ journal June 2004
Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia journal July 2022
Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening journal August 2011
Accurate segmentation of head and neck radiotherapy CT scans with 3D CNNs: consistency is key journal April 2023
Information Extraction for Tracking Liver Cancer Patients' Statuses: From Mixture of Clinical Narrative Report Types journal September 2013
External validation of prognostic models: what, why, how, when and where? journal November 2020
The therapy is making me sick: how online portal communications between breast cancer patients and physicians indicate medication discontinuation journal October 2018
Physician understanding, explainability, and trust in a hypothetical machine learning risk calculator journal February 2020
Accuracy and Efficiency of Deep-Learning–Based Automation of Dual Stain Cytology in Cervical Cancer Screening journal June 2020
The Association of Veterans’ PSA Screening Rates With Changes in USPSTF Recommendations journal August 2020
Deep Learning vs Traditional Breast Cancer Risk Models to Support Risk-Based Mammography Screening journal July 2022
Use of artificial intelligence for cancer clinical trial enrollment: a systematic review and meta-analysis journal January 2023
Influence of Publication of US and European Prostate Cancer Screening Trials on PSA Testing Practices journal February 2011
Overdiagnosis and Lives Saved by Reflex Testing Men With Intermediate Prostate-Specific Antigen Levels journal June 2019
Identifying Symptom Information in Clinical Notes Using Natural Language Processing journal May 2021
Whole Slide Imaging: Technology and Applications journal May 2020
Dissecting racial bias in an algorithm used to manage the health of populations journal October 2019
Big data and black-box medical algorithms journal December 2018
Artificial intelligence versus clinicians: systematic review of design, reporting standards, and claims of deep learning studies journal March 2020
Use of artificial intelligence for image analysis in breast cancer screening programmes: systematic review of test accuracy journal September 2021
Lymph Node Metastasis Prediction from Primary Breast Cancer US Images Using Deep Learning journal January 2020
Deep Learning–based Assessment of Oncologic Outcomes from Natural Language Processing of Structured Radiology Reports journal September 2022
Automated Classification of Lung Cancer Types from Cytological Images Using Deep Convolutional Neural Networks journal January 2017
DeepPhe: A Natural Language Processing System for Extracting Cancer Phenotypes from Clinical Records journal October 2017
Use of Natural Language Processing to Extract Clinical Cancer Phenotypes from Electronic Medical Records journal November 2019
Real-World Evidence in Support of Oncology Product Registration: A Systematic Review of New Drug Application and Biologics License Application Approvals from 2015–2020 journal October 2021
Deep Learning to Estimate RECIST in Patients with NSCLC Treated with PD-1 Blockade journal January 2021
There is no such thing as a validated prediction model journal February 2023
Machine Learning–Based Interpretation and Visualization of Nonlinear Interactions in Prostate Cancer Survival journal November 2020
Automated NLP Extraction of Clinical Rationale for Treatment Discontinuation in Breast Cancer journal December 2021
Automated Electronic Health Record–Based Tool for Identification of Patients With Metastatic Disease to Facilitate Clinical Trial Patient Ascertainment journal December 2021
Ascertainment of Veterans With Metastatic Prostate Cancer in Electronic Health Records: Demonstrating the Case for Natural Language Processing journal December 2021
Automated Extraction of Tumor Staging and Diagnosis Information From Surgical Pathology Reports journal December 2021
Deep Learning for Cancer Symptoms Monitoring on the Basis of Electronic Health Record Unstructured Clinical Notes journal June 2022
Multi-Institutional Validation of Deep Learning for Pretreatment Identification of Extranodal Extension in Head and Neck Squamous Cell Carcinoma journal April 2020
Selection bias in clinical trials. journal August 1985
System for High-Intensity Evaluation During Radiation Therapy (SHIELD-RT): A Prospective Randomized Study of Machine Learning–Directed Clinical Evaluations During Radiation and Chemoradiation journal November 2020
Improved Method to Stratify Elderly Patients With Cancer at Risk for Competing Events journal April 2016
Sybil: A Validated Deep Learning Model to Predict Future Lung Cancer Risk From a Single Low-Dose Chest Computed Tomography journal April 2023
Understanding Molecular Testing Uptake Across Tumor Types in Eight Countries: Results From a Multinational Cross-Sectional Survey journal August 2020
Comparing deep learning and concept extraction based methods for patient phenotyping from clinical narratives journal February 2018
Large language models are few-shot clinical information extractors conference January 2022
Radiomics in cancer diagnosis, cancer staging, and prediction of response to treatment journal August 2016
Natural Language Processing and Machine Learning Methods to Characterize Unstructured Patient-Reported Outcomes: Validation Study journal November 2021
A clinical evaluation of the performance of five commercial artificial intelligence contouring systems for radiotherapy journal August 2023
Explainable AI: A Review of Machine Learning Interpretability Methods journal December 2020

Figures / Tables (1)


Similar Records

Clinical Natural Language Processing for Radiation Oncology: A Review and Practical Primer
Journal Article · Thu Jul 15 00:00:00 EDT 2021 · International Journal of Radiation Oncology, Biology and Physics · OSTI ID:23198546

Use of conditional rule structure to automate clinical decision support: a comparison of artificial intelligence and deterministic programming techniques
Journal Article · Mon Aug 01 00:00:00 EDT 1983 · Comput. Biomed. Res.; (United States) · OSTI ID:5304436

Introduction to artificial intelligence
Journal Article · Tue Sep 01 00:00:00 EDT 1987 · Chem. Eng. Prog.; (United States) · OSTI ID:5756715