Abstract 3648: AI-enabled 3D multimodal integration platform reveals subcellular architecture of tumor immune microenvironment for therapeutic target and biomarker discovery and patient selection
Background: Tumor immune microenvironment (TIME) organization fundamentally shapes cancer progression and immunotherapy outcomes. Traditional 2D spatial molecular approaches inadequately capture the complex three-dimensional architecture and cellular interactions within TIME. We developed an AI-driven platform integrating multiple spatial molecular datasets, enabling comprehensive 3D visualization for therapeutic discovery and patient selection. Methods: Our platform combines holotomography imaging, providing 3D refractive index maps, with diverse spatial molecular data: in situ molecular imaging, spatial proteomics, multiplex immunohistochemistry, and spatial transcriptomics. AI algorithms align datasets within a unified 3D coordinate system, while Poisson implicit surface reconstruction generates subcellular-resolution models. Platform validation used clinical samples from immunotherapy-treated patients. Results: The platform integrated multimodal spatial data into high-resolution 3D TIME representations, revealing novel relationships between protein expression, transcriptional patterns, and cellular architecture. 3D surface protein analysis with subcellular morphology identified patients with target protein expression outside tight junctions, indicating higher risk for adverse effects from antibody-drug conjugates and cellular therapies. This insight, unavailable through 2D analysis, enabled precise patient selection. Conclusions: This platform provides detailed subcellular-resolution TIME architecture analysis, offering actionable insights for therapeutic targeting, biomarker discovery, and patient selection. AI-driven 3D spatial multimodal TIME analysis advances precision medicine across multiple therapeutic approaches, including immunotherapy, targeted therapy, and drug delivery optimization. AI Disclosure: Original abstract content was written by the authors. Claude was used for editorial assistance and formatting without altering the scientific content or context of the work. Citation Format: Inyeop Jang, Yoonho Choi, Minji Kim, Jeonghwan Park, Jiyeon Sung, Byungsoo Ann, Clemenceau R. Jean, TaeHyun Hwang. AI-enabled 3D multimodal integration platform reveals subcellular architecture of tumor immune microenvironment for therapeutic target and biomarker discovery and patient selection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3648.
Abstract 7385: Explainable AI model incorporating uncertainty estimation for enhanced MSI-H prediction and immunotherapy response in gastrointestinal cancer
Abstract Background: Microsatellite instability-high (MSI-H) tumors respond well to immune checkpoint blockade and oftentimes not to chemotherapeutics. Despite value of determining MSI status to guide therapy, many patients’ samples are not untested. Deep learning models may be able to predict MSI status by analyzing hematoxylin and eosin (H&E) stained whole-slide images (WSIs). Validation of this tool will provide another tool to increase MSI testing. However, to be deployed into clinical routine care, prediction models need be externally validated in large and diverse patient cohorts. In addition, these models should provide uncertainty of prediction to help clinicians make informed decisions. Results: In this study, we introduce a novel Bayesian prediction model using whole-slide images (WSIs) and deep Gaussian processes (DGPs) in a weakly supervised learning context. Extensively tested on large datasets (n=3,146) from multiple centers, our model not only demonstrated superior performance but also showed that incorporating uncertainty into predictions significantly improves MSI prediction accuracy, achieving AUROC of >0.91 in colon cancer and >0.94 in gastric cancer. Additionally, an in-depth analysis within the gastric cancer cohort indicated a significant correlation between predicted MSI-H regions and immunotherapy response. Patients who responded to immune checkpoint inhibitors had a higher proportion of MSI-H regions (P-value < 0.05). This correlation was also observed in patients categorized as MSS but responsive to ICIs, highlighting the potential of our model to identify MSI-H patterns not detected through standard laboratory tests. This advancement could lead to more precise patient selection for ICI therapy, enhancing personalized treatment strategies in gastrointestinal cancer. Citation Format: Sunho Park, Minj Kim, Ji-Youn Sung, Jeong Hwan Park, Sung Hak Lee, Sam C. Wang, Jaeho Cheong, Tae Hyun Hwang. Explainable AI model incorporating uncertainty estimation for enhanced MSI-H prediction and immunotherapy response in gastrointestinal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7385.
Abstract 7400: AI-driven multimodal 3D tumor modeling with spatial molecular insights for predicting ICI response in gastric cancer
Abstract Traditional cancer research methodologies predominantly focus on 2D tumor modeling, including spatial profiling and AI-driven analysis at the 2D level. To advance beyond these limitations, we implemented Holotomography (HT), a 3D, label-free optical imaging method. This technique, leveraging refractive index contrasts, allows for enhanced visualization of tumor tissues, organoids, and cells in three dimensions. Using serial H&E sections and unstained slides, we created detailed 3D tumor models in gastric cancer, providing insights into tumor, immune, and stromal composition, as well as cell-cell interactions and extracellular matrix characteristics. AI algorithms further enhanced our 3D tumor modeling, offering novel perspectives on the initiation and progression of tumor, immune, and stromal components at the subcellular level. Analyzing gastric tumors treated with immune checkpoint inhibitors before, during, and after treatment revealed dynamic changes in spatial composition over time, offering unique insights into the evolution of the 3D tumor ecosystem. Additionally, by integrating spatial transcriptomic and in situ molecular imaging data, we developed a novel Multimodal 3D Tumor Model. This model not only uncovers subcellular-level molecular characteristics but also elucidates cellular interactions during treatment, suggesting potential biomarkers and therapeutic approaches. Lastly, by constructing 3D cellular interaction networks incorporating true 3D interactions, we provided an in-depth view of cellular communication within the tumor microenvironment. This pioneering approach, representing the first Multimodal 3D Tumor Model at the subcellular level, offers novel insights into gastric cancer's spatial evolution, potentially revolutionizing our understanding and treatment of gastric cancer. Citation Format: Yoon Ho Choi, Minji Kim, Katya Redekop, Inyeop Jang, Jean R. Clemenceau, Isabel Barnfather, Sumanth Reddy Nakkireddy, Changjin Hong, Sunho Park, Ji-Youn Sung, Jeong Hwan Park, Shitara Kohei, Aoki Yu, Sung Hak Lee, Sam Wang, Jaeho Cheong, Tae Hyun Hwang. AI-driven multimodal 3D tumor modeling with spatial molecular insights for predicting ICI response in gastric cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7400.