Previously submitted to: Journal of Medical Internet Research (no longer under consideration since May 17, 2021)
Date Submitted: Feb 4, 2021
Open Peer Review Period: Feb 4, 2021 - Apr 4, 2021
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A Machine Learning Algorithm to Predict Hyperglycemic Cases Induced by PD-1/PD-L1 Inhibitors in the Real World
ABSTRACT
Background:
Diabetes mellitus and cancer are amongst the leading causes of deaths worldwide; hyperglycemia plays a major contributory role in neoplastic transformation risk. Support Vector Machine (SVM) is a type of supervised learning method which analyzes data and recognizes patterns, mainly used for statistical classification and regression.
Objective:
From reported adverse events of PD-1 or PD-L1 (programmed death 1 or ligand 1) inhibitors in post-marketing monitoring, we aimed to construct an effective machine learning algorithm to predict the probability of hyperglycemic adverse reaction from PD-1/PD-L1 inhibitors treated patients efficiently and rapidly.
Methods:
Raw data was downloaded from US Food and Drug Administration Adverse Event Reporting System (FDA FAERS). Signal of relationship between drug and adverse reaction based on disproportionality analysis and Bayesian analysis. A multivariate pattern classification of SVM was used to construct classifier to separate adverse hyperglycemic reaction patients. A 10-fold-3-time cross validation for model setup within training data (80% data) output best parameter values in SVM within R software. The model was validated in each testing data (20% data) and two total drug data, with exactly predictor parameter variables: gamma and nu.
Results:
Total 95918 case files were downloaded from 7 relevant drugs (cemiplimab, avelumab, durvalumab, atezolizumab, pembrolizumab, ipilimumab, nivolumab). The number-type/number-optimization method was selected to optimize model. Both gamma and nu values correlated with case number showed high adjusted r2 in curve regressions (both r2 >0.95). Indexes of accuracy, F1 score, kappa and sensitivity were greatly improved from the prediction model in training data and two total drug data.
Conclusions:
The SVM prediction model established here can non-invasively and precisely predict occurrence of hyperglycemic adverse drug reaction (ADR) in PD-1/PD-L1 inhibitors treated patients. Such information is vital to overcome ADR and to improve outcomes by distinguish high hyperglycemia-risk patients, and this machine learning algorithm can eventually add value onto clinical decision making. Clinical Trial: N/A
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