Predicting Personalised Therapeutic Combinations in Non-Small Cell Lung Cancer Using In Silico Modelling
Bibliographic record
Abstract
Abstract The disease burden from non-small cell lung cancer (NSCLC) adenocarcinoma is substantial, with around a million new cases diagnosed globally each year, and a 5-year survival rate of less than 20%. A lack of therapeutic options personalized to individual patient genetics, and the targeted therapies that exist quickly succumbing to resistance, leads to high variation in survival. Patient stratification combined with greater personalisation of therapies have the potential to improve outcomes, however, the wide variation in mutations found in NSCLC adenocarcinoma patients mean that experimentally determining suitable treatment combinations is time-consuming and expensive. Here we present an in silico model encompassing tumour intrinsic key oncogenic signalling pathways, including EGFR, AKT, JAK/STAT and WNT for efficiently predicting rational drug-drug and drug-radiotherapy combination therapies in NSCLC. Using this model, we simulate diverse genetic profiles and test over 10,000 therapeutic combinations to identify optimal strategies to overcome resistance mechanisms specific to genetic profiles and p53 status. Our in silico model reproduces drug additivity experiments, predicts radio-sensitising genes validated in a CRISPR screen and identifies 53BP1 as a potential drug target that improves the therapeutic window during radiotherapy, as well as potential to use ATM inhibitors to overcome p53 loss-of-function driven radiotherapy resistance. We further use the in silico model to identify a 19-gene signature to stratify patients most likely to benefit from radiotherapy and validated this using TCGA data. These results further demonstrate the utility of in silico mechanistic modelling and present a bespoke computational resource for large-scale screening of personalised therapies applied to NSCLC.
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".