Dynamic Risk Profiling Using Serial Tumor Biomarkers for Personalized Outcome Prediction

David M. Kurtz, Mohammad S. Esfahani, Florian Scherer, Joanne Soo, Michael C. Jin, Chih Long Liu, Aaron M. Newman, Ulrich Dührsen, Andreas Hüttmann, Olivier Casasnovas, Jason R. Westin, Matthais Ritgen, Sebastian Böttcher, Anton W. Langerak, Mark Roschewski, Wyndham H. Wilson, Gianluca Gaidano, Davide Rossi, Jasmin Bahlo, Michael HallekRobert Tibshirani, Maximilian Diehn, Ash A. Alizadeh

Research output: Contribution to journalArticlepeer-review

127 Scopus citations

Abstract

Accurate prediction of long-term outcomes remains a challenge in the care of cancer patients. Due to the difficulty of serial tumor sampling, previous prediction tools have focused on pretreatment factors. However, emerging non-invasive diagnostics have increased opportunities for serial tumor assessments. We describe the Continuous Individualized Risk Index (CIRI), a method to dynamically determine outcome probabilities for individual patients utilizing risk predictors acquired over time. Similar to “win probability” models in other fields, CIRI provides a real-time probability by integrating risk assessments throughout a patient's course. Applying CIRI to patients with diffuse large B cell lymphoma, we demonstrate improved outcome prediction compared to conventional risk models. We demonstrate CIRI's broader utility in analogous models of chronic lymphocytic leukemia and breast adenocarcinoma and perform a proof-of-concept analysis demonstrating how CIRI could be used to develop predictive biomarkers for therapy selection. We envision that dynamic risk assessment will facilitate personalized medicine and enable innovative therapeutic paradigms.

Original languageEnglish (US)
Pages (from-to)699-713.e19
JournalCell
Volume178
Issue number3
DOIs
StatePublished - Jul 25 2019

Keywords

  • biomarkers
  • cancer
  • liquid biopsy
  • personalized medicine
  • predictive modeling

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology

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