A multimodal synergistic model for personalized neoadjuvant immunochemotherapy in esophageal cancer.
Authors
Affiliations (13)
Affiliations (13)
- Department of Pathology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou 510006, China.
- Department of Pathology, Cancer Hospital of Shantou University Medical College, Shantou 515031, China.
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
- Centre for Inflammation Research, Institute of Regeneration and Repair, University of Edinburgh, EH16 4UU Edinburgh, UK.
- Thoracic Surgery Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
- Department of Chest Surgery, Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou 515031, China.
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
- Guangdong Esophageal Cancer Institute, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou 510006, China. Electronic address: [email protected].
- Thoracic Surgery Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China. Electronic address: [email protected].
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. Electronic address: [email protected].
- Department of Pathology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. Electronic address: [email protected].
Abstract
Neoadjuvant immunochemotherapy (nICT) has significantly improved the treatment of locally advanced esophageal cancer (EC), yet accurately identifying patients' response remains a major challenge. In this study, we introduce eSPARK, a multimodal framework designed to integrate routinely available clinical data for informed decision-making in nICT treatment for EC. The model is developed using 344 patients from three independent regions, each with pre-treatment-paired computed tomography (CT) imaging and pathological slides, and postoperative pathological complete response (pCR) outcomes. By incorporating cytological semantic information, eSPARK demonstrates superior generalizability, outperforming single-modality models and achieving robust predictive accuracy across multicenter datasets. Additionally, a multi-scale interpretability module identifies several biomarkers, including the neutrophil-to-lymphocyte ratio (NLR) in the tumor microenvironment, associated with nICT response. Our findings underscore the potential of eSPARK as a powerful tool for personalized therapeutic decision-making in locally advanced EC and its broader implications for advancing precision oncology through multidisciplinary data integration.