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评估由沃森基因组学平台进行的临床基因组序列分析。

Evaluating Clinical Genome Sequence Analysis by Watson for Genomics.

作者信息

Itahashi Kota, Kondo Shunsuke, Kubo Takashi, Fujiwara Yutaka, Kato Mamoru, Ichikawa Hitoshi, Koyama Takahiko, Tokumasu Reitaro, Xu Jia, Huettner Claudia S, Michelini Vanessa V, Parida Laxmi, Kohno Takashi, Yamamoto Noboru

机构信息

Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Front Med (Lausanne). 2018 Nov 9;5:305. doi: 10.3389/fmed.2018.00305. eCollection 2018.

Abstract

Oncologists increasingly rely on clinical genome sequencing to pursue effective, molecularly targeted therapies. This study assesses the validity and utility of the artificial intelligence Watson for Genomics (WfG) for analyzing clinical sequencing results. This study identified patients with solid tumors who participated in in-house genome sequencing projects at a single cancer specialty hospital between April 2013 and October 2016. Targeted genome sequencing results of these patients' tumors, previously analyzed by multidisciplinary specialists at the hospital, were reanalyzed by WfG. This study measures the concordance between the two evaluations. In 198 patients, in-house genome sequencing detected 785 gene mutations, 40 amplifications, and 22 fusions after eliminating single nucleotide polymorphisms. Breast cancer ( = 40) was the most frequent diagnosis in this analysis, followed by gastric cancer ( = 31), and lung cancer ( = 30). Frequently detected single nucleotide variants were found in ( = 107), ( = 24), and ( = 23). ( = 10) was the most frequently detected gene amplification, followed by ( = 9) and ( = 6). Concordant pathogenic classifications (i.e., pathogenic, benign, or variant of unknown significance) between in-house specialists and WfG included 705 mutations (89.8%; 95% CI, 87.5%-91.8%), 39 amplifications (97.5%; 95% CI, 86.8-99.9%), and 17 fusions (77.3%; 95% CI, 54.6-92.2%). After about 12 months, reanalysis using a more recent version of WfG demonstrated a better concordance rate of 94.5% (95% CI, 92.7-96.0%) for gene mutations. Across the 249 gene alterations determined to be pathogenic by both methods, including mutations, amplifications, and fusions, WfG covered 84.6% (88 of 104) of all targeted therapies that experts proposed and offered an additional 225 therapeutic options. WfG was able to scour large volumes of data from scientific studies and databases to analyze in-house clinical genome sequencing results and demonstrated the potential for application to clinical practice; however, we must train WfG in clinical trial settings.

摘要

肿瘤学家越来越依赖临床基因组测序来寻求有效的分子靶向治疗。本研究评估了人工智能基因组学沃森(WfG)分析临床测序结果的有效性和实用性。本研究纳入了2013年4月至2016年10月期间在一家癌症专科医院参与内部基因组测序项目的实体瘤患者。这些患者肿瘤的靶向基因组测序结果此前由医院的多学科专家进行了分析,现由WfG重新分析。本研究测量了两种评估结果之间的一致性。在198例患者中,内部基因组测序在排除单核苷酸多态性后检测到785个基因突变、40个基因扩增和22个基因融合。在该分析中,乳腺癌(n = 40)是最常见的诊断,其次是胃癌(n = 31)和肺癌(n = 30)。常见的单核苷酸变异见于TP53(n = 107)、KRAS(n = 24)和PIK3CA(n = 23)。CCND1(n = 10)是最常检测到的基因扩增,其次是MYC(n = 9)和EGFR(n = 6)。内部专家与WfG之间一致的致病分类(即致病、良性或意义未明的变异)包括705个突变(89.8%;95%CI,87.5%-91.8%)、39个扩增(97.5%;95%CI,86.8-99.9%)和17个融合(77.3%;95%CI,54.6-92.2%)。大约12个月后,使用更新版本的WfG进行重新分析显示,基因突变的一致性率更高,为94.5%(95%CI,92.7-96.0%)。在两种方法均确定为致病的249个基因改变中,包括突变、扩增和融合,WfG涵盖了专家提出的所有靶向治疗的84.6%(104个中的88个),并提供了另外225个治疗选择。WfG能够从科学研究和数据库中筛选大量数据,以分析内部临床基因组测序结果,并显示出应用于临床实践的潜力;然而,我们必须在临床试验环境中对WfG进行培训。

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