The present invention relates to a novel method of predicting classes of patients for medical treatment.
Gene expression analysis provides the foundation for studying thousands of individual alterations in gene function. These alterations in mRNA expression can be viewed as biomarkers. Whole genome gene expression assays are routinely used to predict treatment responses in human diseases (Xiang et al. Curr Opin Drug Discov Devel. 2003; 6:384-95; and Lee J. S. and Thorgeirsso, S. S. Gastroenterology 2004; 127:S51-55). A major limitation with the gene expression data analysis methods is the low prediction accuracy with small sample size (Roepman P. Bioanalysis 2010; 2:249-62). Studies have indicated that the prediction accuracy can be increased by increasing the sample size. For example, Ein-Dor et al. reported that ˜3000 samples are needed to get good prediction accuracy necessary for the clinical applications in lung cancer (Proc Natl Acad Sci USA 2006; 103:5923-5928). It has also been proposed that gene expression data can be supplemented with copy number variation and Single Nucleotide Polymorphism (SNP) information to obtain the accuracy required for class prediction (Kalia M. Metabolism 2013; 62:S11-14). Using more than one technique, however, will increase the cost of the test and also the complexity associated with the present data analysis methods.
Currently, a supervised clustering method is used to analyze microarray data to classify a patient for treatment response (Speed, T. (Ed.) 2003 Statistical analysis of gene expression microarray data. Chapman and Hall/CRC, NewYork).
The goal of these approaches is to relate gene expression to different target classes and to use this new information to produce a prediction model. Often, this approach is called pattern recognition. There are many different algorithms, such as linear predictors, neural nets, etc. These are very powerful tools, but each has its own advantages and disadvantages. One would need to know how to select the right method, structure, and definition for a given problem. This approach may not provide accurate results to take clinical decision. For example, a prediction model developed by Gordon et al. could reach only 74% predicting accuracy with ˜400 samples; a good outcome but not excellent result (Gordon et al. Can Epidemiol Biomarkers Prev 2003; 12: 905-910).
Musical algorithms have been widely used to compose tunes for entertainment purposes. There is a limited usage in medical musical therapy applications (Carr et al. PLoS One 2013; 8:e70252).
The present invention relates to a method of using a mathematical musical orchestral algorithm, referred to herein as MMOA, to predict response of a patient suffering from a disease to a selected treatment for the disease. As demonstrated herein, this novel MMOA is suitable for small sample size with high prediction accuracy.
Accordingly, an aspect of the present invention relates to a method of classifying a patient suffering from a disease as a responder or a non-responder to a selected treatment for the disease.
In one embodiment, the disease is cancer.
In one embodiment, the disease is lung cancer.
This method comprises first analyzing a tissue sample from the patient with a microarray. The data set generated from the microarray is then filtered using a standard microarray data analysis method and an audio tune and/or sound frequency pattern capturing the filtered data from the microarray is then established via the MMOA. The patient is then classified as a non-responder or responder to the selected treatment based upon the assigned audio tune and/or sound frequency pattern being similar to an audio tune and/or sound frequency pattern already previously identified for known responders or known non-responders.
In one embodiment of the present invention, the MMOA is manually operated.
In another embodiment, a web based program converted from the manually operated MMOA and referred to as sound frequency pattern generation and recognition algorithm or SFPGRA is used.
The classification method of the present invention is also useful in predicting recurrence of a disease such as cancer in a patient.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the methods and materials are described herein. All publications, patent applications, patents and other references mentioned herein are incorporated by reference in their entirety. In the case of conflict, the present specification, including definitions, will control. In addition, the materials, methods and examples are illustrative only and are not intended to be limiting.
Other features and advantages of the invention will be apparent from the detailed description, and from the claims.
Musical algorithms are used widely to compose tunes for entertainment purposes. Usage in medical musical therapy applications has been quite limited.
Since conventional machine learning algorithms cannot achieve the prediction accuracy required in a clinical setting for classifying patients suffering from a disease as responders or non-responders to a selected treatment, in the present invention a mathematical musical orchestral algorithm, referred to herein as MMOA, was integrated into the machine learning process. The MMOA is capable of handling complete gene expression data obtained from whole human genome microarray comprised of ˜30,000 human genes. It can be used to analyze more than one clinical parameter such as stage, age, gender and smoking history etc. for class/sub-class predication purposes. It can be also used to predict responses such as, but not limited to, chemotherapy or radiology or targeted therapy response in patients suffering from late stage cancers.
The MMOA can be used for sub-class identification as well. For example, in the first step it can be used to discriminate non-responder from responder after, for example, a surgical treatment. The same algorithm can be used to prediction adjuvant chemotherapy response or radiotherapy or targeted therapy response in non-responder patients who are eligible for adjuvant chemotherapy or radio or targeted therapy.
As shown herein, the combination of mathematical machine learning and MMOA can greatly improve the prediction accuracy of the treatment response in patients suffering from cancer.
In the method of the present invention, a patient suffering from a disease is classified as a responder or a non-responder to a selected treatment for the disease by analyzing a sample from the patient using an RNA, DNA or protein microarray. In one embodiment, if the patient is suffering from cancer, the tumor or a portion thereof is excised from the patient for analysis. Core needle biopsy samples, fine needle aspirations as well as fresh, frozen and formalin-fixed paraffin-embedded tissues samples may also be used.
The data set generated from the microarray is then filtered. An audio tune and/or sound frequency pattern capturing the filtered data from the microarray is then assigned to the patient and the patient is classified as a responder or a non-responder to a selected treatment for the disease based upon the assigned audio tune and/or sound frequency pattern.
The method of the present invention was tested using a Non-Small Cell Lung Cancer (NSCLC) model. At present most of the Stage Ia NSCLC patients are not treated with adjuvant chemotherapy (Qi-Zhu et al. J Clin Onco 2010; 28: 4417-4424). Early identification of stage Ia patients likely to recur following surgery will allow the physician to target adjuvant chemotherapy to those patients for whom it is necessary. In stage Ib diseases, most of the patients are treated with adjuvant chemotherapy. However, a subgroup of patients do not recur and hence might not require adjuvant chemotherapy. In stage Ib patients, physician can avoid adjuvant chemotherapy to those who do not require it. Conventional detection and follow-up methods based on the clinical staging and clinic-pathological findings are insufficient to predict recurrence (Sriram et al. Respirology 2011; 16: 257-263).
In the present invention, the MMOA was used to convert mRNA signal intensities into musical notes/sound frequencies and class specific tunes/SFPs were composed/generated with the harmonized musical notes/SFPs. By listening and observing the class specific tunes/SFPs, one can discriminate the responders from non-responders of surgical treatment in these NSCLC patients.
While tests were performed on lung cancer patients, as will be understood by the skilled artisan upon reading this disclosure, the method of the present invention provides a simple, sensitive and cost-effective method which can be routinely used in any kind of human disease.
It is important to note that present gene expression data analysis methods considered mRNAs as the inert molecules and use their concentration information (signal intensity) to predict treatment response. In contrast, the present invention considers mRNAs as the vibrating molecules, and uses their macromolecular vibrations/SFPs extracted (from their signal intensity values) for class prediction.
Accordingly, the method of the present invention utilizes what is believed to be the first gene expression algorithm that involves two human senses (i.e. visual and listening) to predict treatment response in human disease. This is believed to also be the first medical laboratory test that uses two human senses for diagnostics applications.
Since the MMOA predictions are based on the tunes/SFPs, it can be effectively used to predict mRNA extracted from Formalin Fixed Paraffin Embedded (FFPE) samples. Even in the absence of some biomarkers, the tunes/SFPs obtained from the remaining expressed genes can be used to identify the clinical outcome of the patient.
The preferred methods and materials are described below in examples which are meant to illustrate, not limit, the invention. Skilled artisans will recognize methods and materials that are similar or equivalent to those described herein, and that can be used in the practice or testing of the present invention.
Conventional gene expression data analysis program uses the concentration/signal intensity information of mRNA to identify the differentially expressed genes for class prediction (Wong et al. Bioinformatics 2007; 23:998-1005). In the present invention, an algorithm referred to herein as MMOA was used to convert the signal intensities (numbers) into macromolecular vibrations/sound frequency patterns (SFPs). Class specific tunes/SFPs were composed/generated using coherent music/SFPs. The class specific tune/SFP was used to predict the clinical outcome of unknown patients. The principle of MMOA is shown in
Comparison with Conventional Microarray Data Analysis
Initially, a conventional microarray data analysis method was used to find out its prediction accuracy. The prediction accuracy of the conventional microarray data analysis was then compared with the MMOA.
Based on the clinical information, patients were classified as a Responder (R) if no recurrence was detected within 5 years after surgery. Otherwise, the patient was considered a Non-responder (NR). Twenty three non-responders and 13 responders were used to build and test the model, and 8 samples were treated as the “unknowns”. Total RNA was amplified and hybridized onto human whole genome microarrays (Affymetrix HGU-133 Plus 2.0). The microarray data was normalized using Robust Multi-array Average (RMA) procedure on Affymetrix GeneChip Operating Software (GCOS). For further analysis, the data was filtered and the probes that do not change were removed from the analysis.
Standard clustering procedures (e.g. hierarchical or sammon map) did not group the samples according to their status of responders or non-responders. Also, according to the limma analysis there were no differentially expressed genes between responders and non-responders group. This indicated that the differences between the two groups is more subtle and has to be addressed using more sophisticated and sensitive analysis. Analysis was performed in R statistical language using standard Bioconductor packages and custom-written code (see http: with the extension //bioconductor.org/ of the world wide web).
The classification model was learned on filtered data from responders (R) and non-responders (NR) using penalized regression procedure. The resulting classifier has a leave one out cross-validation accuracy of 0.89. In other words, the error of misclassification in training data is 0.11 implying that 9 out of 10 patients/samples are predicted correctly.
A confusion matrix of the classifier is given by the following:
One out of 23 non-responders (NR) 1 was incorrectly predicted, and 3 out of 13 responders (R) were incorrectly classified in a leave-one-out cross-validation procedure.
Classifier built on the training dataset was applied to predict the clinical outcome of the 8 unknown patients.
Mathematical Musical Orchestral Algorithm (MMOA)
A conversion rule was formulated to decipher the numbers (gene expression data/signal intensities) into musical notes/sound frequencies (see Table 1). After converting the numbers into pitches with rhythms, the notes were looked as a whole group. A pattern generation algorithm was created to generate sound frequency patterns (SFPs) ex: a string of eight notes from G to E or recurring notes ex: a lot of G or F. A key/tonal center i.e. G major and F minor respectively were selected to compose the music/generate SFPs. A coherent piece of music/SFP was composed/generated by observing and listening to the music. A reference/theme/framework tune or reference SFP was composed/generated using the NR and R mean values (see
In step 1, a conversion rule was formulated to decipher the numbers (gene expression data) into musical notes/sound frequencies (see Table 1 below).
In step 2, after converting the numbers into pitches with rhythms, the notes were looked at as a whole group.
In step 3, a composition/pattern generation algorithm was created to generate SFPs with the notes/sound frequencies and the rules for composition as follows:
In step 4, a reference/theme/framework music/SFP specific to each group (NR reference and R reference) was composed/generated using non-responders and responders mean values (see
In step 5, the theme/framework tune/SFP was used as the reference music/SFP to compose/generate the training sets (i.e. known non-responder and responder tunes/SFPs) to train the model (see
In step 6, the tunes/SFPs were finalized by listening to the composition and observing the SFPs, and further refined to match with the reference/theme music/SFP by adjusting the location of the note or tempo, etc.
In step 7, data from 8 patients were considered as the test data set (i.e. unknowns). A double blind test was performed to identify clinical outcome of the unknowns after composing/generating the tune/SFP (see
In step 8, initially the entire gene expression data were converted into musical notes using excel program and with the help of a music composer. Manual MMOA took a longer time for class prediction. The manually operated MMOA program was converted into cloud/web based software (SFPGRA). The program can be operated using any of the following programs. The wire frames used for the SFPGRA are listed in
Audio Files
The tunes/SFPs can be listened to by playing any musical instrument mode using any musical software. For these tests, the audios (midi files) were recorded in violin and piano playing mode. Two tunes/SFPs (NR reference and R ref) were composed as the reference/theme tunes/SFPs. Three NR tunes/SFPs and three R tunes/SFPs were composed/generated as the training set. Eight tunes (4NR and 4R) were composed/generated to test and validate the model.
Deconvolution of Musical Notes/Sound Frequencies to Signal Intensity and Gene Symbol/ID
The tunes/SFPs are readily converted back to signal intensity and gene symbol/ID using a deconvolution program. It can be linked to pathway analysis tools and public data bases. The schematic detail of the deconvolution program is shown in
Conventional Microarray Data Analysis
The microarray data was normalized using Robust Multi-array Average (RMA) procedure on Affymetrix GeneChip Operating Software (GCOS). For further analysis, the data was filtered and the probes that do not change were removed from the analysis. The data was further analyzed in R statistical language using standard Bioconductor packages and custom written codes. The top 50 biomarkers and their signal intensities used for class prediction are shown in Table 2.
Classifier built on the training dataset was applied to predict the clinical outcome of the 8 unknown patients (unknown test data set). The results are show in Table 3. To determine prediction accuracy, sample and data permutations were performed. Each sample was removed, and about 80% percent of genes were randomly sampled 1000 times from the filtered data-set. Each time the classifier learning procedure was repeated and then applied to unknown patients to predict the outcome. Prediction accuracies for 7 unknown patients are very high, around or higher than 95% (with about 2-3% confidence interval). The sample unknown 4 predicted as non-respondent with confidence accuracy within 61%-72%. The prediction accuracy was later compared with the original clinical outcome of the patients (Table 3). The prediction accuracy was found to be 62.5%. Three samples (marked *) out 8 samples were predicted incorrectly.
Prediction accuracy of MMOA is shown in Table 4. Eight tunes/SFPs were composed to validate the algorithm and they were predicted with 100% accuracy in double blind studies.
This patent application is the National Stage of International Application No. PCT/US2014/026982 filed Mar. 14, 2014, which claims the benefit of priority from U.S. Provisional Application Ser. No. 61/782,033 filed Mar. 14, 2013, the content of each of which is hereby incorporated by reference in their entirety.
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PCT/US2014/026982 | 3/14/2014 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2014/152129 | 9/25/2014 | WO | A |
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20100247580 | Coche | Sep 2010 | A1 |
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