Zhang, Z M

Clinical trial enrichment is the targeted recruitment of prospective individual patients with defined clinical characteristics who are likely to benefit from newly developed or repurposed drugs. This process is central to the success of clinical trials together with patient management and regulatory compliance. A main challenge in clinical trial enrichment lies in the recognition of a priori clinical parameters and information that informs drug efficacy or toxicity, particularly when intended for a broader unseen population. Although Artificial Intelligence (AI) approaches, especially large language models (LLMs), have been employed in many aspects of clinical trials, to our knowledge, there is no AI method that has been developed which offers a prospective prediction and assesses the extent to which a given therapeutic intervention benefits an unseen population. Here, we offer an outlook on how to build Artificial Clinic Intelligence (ACI), a generative AI (GAI)-powered modeling platform for modeling clinical trial enrichment. ACI generates synthetic patient data and models clinical trial enrichment to inform clinicians on key clinical parameters that are enriched in prospective patients prior to accrual.

ABSTRACT Symmetry refers to properties that remain invariant upon mathematical transformations. The principles of symmetry have guided numerous important discoveries in physics and chemistry but not in biology and medicine. Here, we aim to explore the presence of symmetry relationships at the gene expression level as a mean to distinguish between healthy and disease states. We deployed Learning-Based Invariant Feature Engineering - LIFE, a hybrid machine learning approach implemented with two symmetric invariant feature functions (IFFs) to identify Invariant Feature Genes (IFGs), which are gene pairs whose IFF single-value outputs remain invariant across individual samples in a given biological phenotype. Our multiclass classification results across the transcriptomes of 25 normal organs, 25 cancer types, and blood samples obtained from 4 different types of neurodegenerative diseases revealed the presence of unique phenotype-specific IFGs. We constructed networks using these IFGs (IF-Nets) and intriguingly, we demonstrated that the hubs could serve as information encoders, capable of reconstructing sample-wise expression values in relation to their counterpart genes. More importantly, we found that hubs of cancer IF-Nets were enriched with both approved and clinical trial drugs, highlighting “symmetry breaking” as a novel approach for treating diseases.

Spatially resolved sequencing technologies help us dissect how cells are organized in space. Several available computational approaches focus on the identification of spatially variable genes (SVGs), genes whose expression patterns vary in space. The detection of SVGs is analogous to the identification of differentially expressed genes and permits us to understand how genes and associated molecular processes are spatially distributed within cellular niches. However, the expression activities of SVGs fail to encode all information inherent in the spatial distribution of cells. Here, we devised a deep learning model, Spatially Informed Artificial Intelligence (SPIN-AI), to identify spatially predictive genes (SPGs), whose expression can predict how cells are organized in space. We used SPIN-AI on spatial transcriptomic data from squamous cell carcinoma (SCC) as a proof of concept. Our results demonstrate that SPGs not only recapitulate the biology of SCC but also identify genes distinct from SVGs. Moreover, we found a substantial number of ribosomal genes that were SPGs but not SVGs. Since SPGs possess the capability to predict spatial cellular organization, we reason that SPGs capture more biologically relevant information for a given cellular niche than SVGs. Thus, SPIN-AI has broad applications for detecting SPGs and uncovering which biological processes play important roles in governing cellular organization.