AI-Powered Digital Histopathology: Predicting Immunotherapy Response Using Deep Learning
Abstract
Immunotherapy has revolutionized cancer treatment, yet predicting which patients will respond remains a major clinical challenge. Current predictive biomarkers, such as PD-L1 expression, have limited accuracy and fail to capture the complex interplay of cells within the tumor microenvironment. Digital histopathology, the analysis of digitized tissue slides, combined with artificial intelligence (AI), offers a novel approach to identify complex morphological patterns that could serve as more robust predictive biomarkers.
Objective: A deep learning model, specifically a convolutional neural network (CNN), was trained on a large, multi-center cohort of digitized tumor slides from patients with non-small cell lung cancer who had received ICI therapy. The model was trained to identify subtle morphological features and the spatial arrangement of tumor cells and tumor-infiltrating lymphocytes. The model’s predictive performance was rigorously validated on an independent, held-out test cohort, and its performance was compared to the predictive accuracy of PD-L1 staining. The AI-powered model successfully predicted immunotherapy response with a high degree of accuracy, achieving an area under the receiver operating characteristic curve (AUC) of 0.88 in the validation cohort.
Full text article
References
Al-Hafdi, F. S., & Alhalafawy, W. S. (2024). Ten Years of Gamification-Based Learning: A Bibliometric Analysis and Systematic Review. International Journal of Interactive Mobile Technologies (iJIM), 18(07), 188–212. https://doi.org/10.3991/ijim.v18i07.45335
Alzahrani, F. K., & Alhalafawy, W. S. (2023). Gamification for Learning Sustainability in the Blackboard System: Motivators and Obstacles from Faculty Members’ Perspectives. Sustainability, 15(5), 4613. https://doi.org/10.3390/su15054613
Bai, S., Hew, K. F., & Huang, B. (2020). Does gamification improve student learning outcome? Evidence from a meta-analysis and synthesis of qualitative data in educational contexts. Educational Research Review, 30, 100322. https://doi.org/10.1016/j.edurev.2020.100322
Buckley, P., & Doyle, E. (2016). Gamification and student motivation. Interactive Learning Environments, 24(6), 1162–1175. https://doi.org/10.1080/10494820.2014.964263
Damaševi?ius, R., Maskeli?nas, R., & Blažauskas, T. (2023). Serious Games and Gamification in Healthcare: A Meta-Review. Information, 14(2), 105. https://doi.org/10.3390/info14020105
Dichev, C., & Dicheva, D. (2017). Gamifying education: What is known, what is believed and what remains uncertain: a critical review. International Journal of Educational Technology in Higher Education, 14(1), 9. https://doi.org/10.1186/s41239-017-0042-5
Domínguez, A., Saenz-de-Navarrete, J., de-Marcos, L., Fernández-Sanz, L., Pagés, C., & Martínez-Herráiz, J.-J. (2013). Gamifying learning experiences: Practical implications and outcomes. Computers & Education, 63, 380–392. https://doi.org/10.1016/j.compedu.2012.12.020
Durrani, U. K., Al Naymat, G., Ayoubi, R. M., Kamal, M. M., & Hussain, H. (2022). Gamified flipped classroom versus traditional classroom learning: Which approach is more efficient in business education? The International Journal of Management Education, 20(1), 100595. https://doi.org/10.1016/j.ijme.2021.100595
Gamarra, M., Dominguez, A., Velazquez, J., & Páez, H. (2022). A gamification strategy in engineering education—A case study on motivation and engagement. Computer Applications in Engineering Education, 30(2), 472–482. https://doi.org/10.1002/cae.22466
Gue, S., Ray, J., & Ganti, L. (2022). Gamification of graduate medical education in an emergency medicine residency program. International Journal of Emergency Medicine, 15(1), 41. https://doi.org/10.1186/s12245-022-00445-1
Hamari, J., Shernoff, D. J., Rowe, E., Coller, B., Asbell-Clarke, J., & Edwards, T. (2016). Challenging games help students learn: An empirical study on engagement, flow and immersion in game-based learning. Computers in Human Behavior, 54, 170–179. https://doi.org/10.1016/j.chb.2015.07.045
Hidayat, W. N., Elmunsyah, H., Bariroh, L. I., & Sutikno, T. A. (2022). Gamification-Based E-learning Design for Vocational Software Engineering Subjects. 2022 14th International Conference on Information Technology and Electrical Engineering (ICITEE), 142–147. https://doi.org/10.1109/ICITEE56407.2022.9954090
Ibanez, M.-B., Di-Serio, A., & Delgado-Kloos, C. (2014). Gamification for Engaging Computer Science Students in Learning Activities: A Case Study. IEEE Transactions on Learning Technologies, 7(3), 291–301. https://doi.org/10.1109/TLT.2014.2329293
Khan, M. A., Merabet, A., Alkaabi, S., & Sayed, H. E. (2022). Game-based learning platform to enhance cybersecurity education. Education and Information Technologies, 27(4), 5153–5177. https://doi.org/10.1007/s10639-021-10807-6
Kumar, A., Saudagar, A. K. J., Alkhathami, M., Alsamani, B., Khan, M. B., Hasanat, M. H. A., Ahmed, Z. H., Kumar, A., & Srinivasan, B. (2023). Gamified Learning and Assessment Using ARCS with Next-Generation AIoMT Integrated 3D Animation and Virtual Reality Simulation. Electronics, 12(4), 835. https://doi.org/10.3390/electronics12040835
Landers, R. N. (2014). Developing a Theory of Gamified Learning: Linking Serious Games and Gamification of Learning. Simulation & Gaming, 45(6), 752–768. https://doi.org/10.1177/1046878114563660
Leitão, R., Maguire, M., Turner, S., Arenas, F., & Guimarães, L. (2022). Ocean literacy gamified: A systematic evaluation of the effect of game elements on students’ learning experience. Environmental Education Research, 28(2), 276–294. https://doi.org/10.1080/13504622.2021.1986469
Leung, A. C. M., Santhanam, R., Kwok, R. C.-W., & Yue, W. T. (2023). Could Gamification Designs Enhance Online Learning Through Personalization? Lessons from a Field Experiment. Information Systems Research, 34(1), 27–49. https://doi.org/10.1287/isre.2022.1123
Ng, L.-K., & Lo, C.-K. (2022). Online Flipped and Gamification Classroom: Risks and Opportunities for the Academic Achievement of Adult Sustainable Learning during COVID-19 Pandemic. Sustainability, 14(19), 12396. https://doi.org/10.3390/su141912396
Santhanam, R., Liu, D., & Shen, W.-C. M. (2016a). Research Note—Gamification of Technology-Mediated Training: Not All Competitions Are the Same. Information Systems Research, 27(2), 453–465. https://doi.org/10.1287/isre.2016.0630
Santhanam, R., Liu, D., & Shen, W.-C. M. (2016b). Research Note—Gamification of Technology-Mediated Training: Not All Competitions Are the Same. Information Systems Research, 27(2), 453–465. https://doi.org/10.1287/isre.2016.0630
Schöbel, S. M., Janson, A., & Leimeister, J. M. (2023). Gamifying Online Training in Management Education to Support Emotional Engagement and Problem-solving Skills. Journal of Management Education, 47(2), 166–203. https://doi.org/10.1177/10525629221123287
Shortt, M., Tilak, S., Kuznetcova, I., Martens, B., & Akinkuolie, B. (2023). Gamification in mobile-assisted language learning: A systematic review of Duolingo literature from public release of 2012 to early 2020. Computer Assisted Language Learning, 36(3), 517–554. https://doi.org/10.1080/09588221.2021.1933540
Thomas, N. J., Baral, R., & Crocco, O. S. (2022). Gamification for HRD: Systematic Review and Future Research Directions. Human Resource Development Review, 21(2), 198–224. https://doi.org/10.1177/15344843221074859
Triantafyllou, S. A., Sapounidis, T., & Farhaoui, Y. (2024). Gamification and Computational Thinking in Education: A systematic literature review. Salud, Ciencia y Tecnología - Serie de Conferencias, 3, 659. https://doi.org/10.56294/sctconf2024659
Ulmer, J., Braun, S., Cheng, C.-T., Dowey, S., & Wollert, J. (2022). Gamification of virtual reality assembly training: Effects of a combined point and level system on motivation and training results. International Journal of Human-Computer Studies, 165, 102854. https://doi.org/10.1016/j.ijhcs.2022.102854
Yu, Q., Yu, K., & Li, B. (2024). Can gamification enhance online learning? Evidence from a meta-analysis. Education and Information Technologies, 29(4), 4055–4083. https://doi.org/10.1007/s10639-023-11977-1
Zourmpakis, A.-I., Kalogiannakis, M., & Papadakis, S. (2023). Adaptive Gamification in Science Education: An Analysis of the Impact of Implementation and Adapted Game Elements on Students’ Motivation. Computers, 12(7), 143. https://doi.org/10.3390/computers12070143