CLEVELAND—A Case Western Reserve University-led team of scientists has used Artificial Intelligence (AI) to identify which patients with certain head and neck cancers would benefit from reducing the intensity of treatments such as radiation therapy and chemotherapy.

The researchers used AI tools similar to those they developed over the last decade at the Center for Computational Imaging and Personal Diagnostics (CCIPD) at Case Western Reserve.

In this case, they asked the computer to analyze digitized images of tissue samples that had been taken from 439 patients from six hospital systems with a type of head and neck cancer, known as human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPCSCC).
The computer program successfully identified a subset of patients who might have benefitted from a significantly reduced dose of radiation therapy.

While that analysis was retrospective—meaning the computer analyzed data from patients in which the eventual outcome was already known—the researchers said their next step could be to test its accuracy in clinical trials.

Their research was published recently in the Journal of the National Cancer Institute.

The work was led by Anant Madabhushi, CCIPD director and the Donnell Institute Professor of Biomedical Engineering at the Case School of Engineering, along with Germán Corredor Prada, a research associate in the CCIPD lab.

‘Overtreating patients’

Although most others with HPV-driven cancer would still benefit from aggressive treatment—along with patients whose cancer was unrelated to the virus—the researchers said their study revealed a significant group was receiving more aggressive therapy than they needed to achieve a favorable outcome.

Clinicians are not able to easily make that distinction simply from simply looking at the tissue scans, the researchers said. So virtually all patients with these cancers—regardless of whether HPV-driven or not—are treated with a full course of chemo and radiation.

“We have been overtreating many patients with chemotherapy and radiation that they do not need because we didn’t have a way to find out which patients would benefit from de-escalation,” Madabhushi said. “We’re saying that now we do—and that someday physicians could modulate the way we care for people and not just give the standard high dose of radiation to everyone who comes through the door.”

Madabhushi said that reducing radiation for these patients could also help lessen the “toxicity of radiation therapy,” meaning that they could experience fewer side effects such as dry mouth, swallowing dysfunction and taste changes.

Rad Oncology Homepage