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Novel Genetic Algorithm-Based Individual Treatment Effect Model for Optimizing Decision-Making: Induction Chemotherapy in Nasopharyngeal Carcinoma
22 Pages Posted: 12 Nov 2024
More...Abstract
Background: Current decision-making models often prioritize risk prediction over treatment effects, leading to suboptimal outcomes. This study aimed to develop an individual treatment effect (ITE) model for predicting induction chemotherapy (IC) efficacy in locoregionally advanced nasopharyngeal carcinoma (LANPC).
Methods: This retrospective study involved 1207 patients with LANPC. An ITE model based on a genetic algorithm was developed to classify treatment benefit: IC-beneficial, IC-ambiguous, and IC-detrimental. Kaplan‒Meier survival analysis was used to assess model performance.
Findings: In the IC-beneficial subgroup, IC treatment decreased the mortality risk by 68% (adjusted P=0·002) and 48% (adjusted P=0·029) in the training and testing sets, respectively. Conversely, in the IC-detrimental group, mortality risks increased by 2·66 (adjusted P=0·031, training set) and 2·11 (adjusted P=0·023, testing set) after IC treatment. Overall survival was not significantly different in the IC-ambiguous group (adjusted P=0·285 and 0·602 in the training and testing cohorts, respectively). Additionally, the ITE score was correlated with short-term treatment efficacy.
Interpretation: The ITE model is a more accurate tool for optimizing IC decisions in LANPC, leading to improved survival and short-term efficacy and enhanced individualized treatment strategies.
Funding: This study was supported by the National Natural Science Foundation of China (grant No.82171906) and National Natural Science Foundation of China-Regional Science Foundation Project (No. 82260358).
Declaration of Interest: The authors declare that they have no competing interests.
Ethical Approval: This retrospective study was approved (B2019-222) by the Ethics Committee of Sun Yat-sen University Cancer Center (SYSUCC) and was conducted in adherence to the principles outlined in the Declaration of Helsinki. The requirement for informed consent was waived owing to the retrospective nature of the study.
Keywords: Nasopharyngeal Carcinoma, Decision-Making, Induction Chemotherapy, Genetic Algorithm
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