TMOD-33. AN INTEGRATED APPROACH COMBINING MATHEMATICAL AND GENOMIC METHODS TO REVEAL THE OPTIMAL TIMING OF THERAPEUTIC INTERVENTION IN WHO GRADE II DIFFUSE GLIOMA
Bibliographic record
Abstract
Abstract BACKGROUND In WHO grade II diffuse gliomas (low-grade gliomas, hereafter called LGGs), chemotherapy and radiotherapy contribute to prolonged survival but could induce somatic mutations. The optimal timing of treatment in LGGs remain poorly understood. To delineate this, we designed a mathematical model for tumor growth and investigate the association among the treatment, malignant transformation (MT), and the accumulation of somatic mutations revealed by whole exome sequencing (WES) in LGGs. METHODS Totally, 290 patients with LGGs between 1990 and 2018 were analyzed. We assessed the statuses of IDH mutation and 1p19q co-deletion in all tumors. Among all, 114 patients (39%) underwent MT during follow-up periods (mean: 82.6 months). Tumor volume was evaluated with FLAIR and/or T2-weighted MRI. MT was evaluated with contrast-enhanced MRI and/or pathological diagnosis. To investigate the number of somatic mutations in a cohort of LGGs and their patient matched recurrence, WES was performed on 88 serial samples collected at least two time-points from 39 patients. RESULTS Oligodendroglioma, IDH-mutant and 1p/19q-codeleted (OD) showed longer transformation-free survival compared to other subtypes. An exponential model was chosen to estimate growth rate in LGGs, since the exponential model provided a better fit to our data as compared to a linear model. The growth rate significantly decreased in the middle of chemotherapy and after radiotherapy. By contrast, these treatments increased the number of somatic mutations identified by WES and the rate of MT in each subtype. The increasing number of mutations in recurrent tumors showed strong correlation with the rise in MT rate. Based on the growth rate and the risk of MT, optimal timing of treatments could be calculated for each genetic subtype. CONCLUSIONS The mathematical model and WES analysis delineates the optimal timing of treatments in each subtype, which will help to decide the treatment for LGGs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".