Predicting targeted- and immunotherapeutic response outcomes in melanoma with single-cell Raman Spectroscopy and AI

PURPOSEIdentifying reliable predictors of immunotherapeutic response in melanoma remains an outstanding challenge. Existing transcriptomic and proteomic profiling methods for the tumor-immune microenvironment (TIME) are costly and may not faithfully capture modifications actively impacting tumor behavior. Here, we present a non-destructive, single-cell approach combining Raman spectroscopy and machine learning (ML) that enables rapid cell profiling and therapeutic response prediction. METHODSWe analyzed single-cell Raman spectra of mouse and human melanoma cell lines alongside nine melanoma patient-derived samples with known resistance profiles to targeted and immunotherapeutic inhibitors bemcentinib, cabozantinib, dabrafenib, nivolumab, and a combination of nivolumab and relatlimab. We assessed cell phenotyping classification and treatment resistance using random forests and feature importance analysis. For patient samples, we constructed a two-stage evaluation workflow to determine clinical drug resistance through aggregated single-cell predictions and identified corresponding highly variant spectral signatures using computational methods adapted from single-cell RNA sequencing methods. RESULTSIn cell lines, our approach achieved >96% differentiation accuracy across tumor microenvironment cell types and induced functional phenotypes. Persistent (drug-resistant) cells formed subclusters based on genetic mutations rather than sample origin, with Raman signatures reflecting biochemical changes relevant to therapeutic pathways. For patient samples, our workflow correctly inferred resistance likelihoods for 30 of 33 clinically-relevant patient-drug combinations (91% accuracy). CONCLUSIONSingle-cell Raman spectroscopy combined with machine learning offers a scalable, prognostic platform to predict therapeutic resistance likelihood, with further potential to advance clinical, multi-omic biomarker efforts for melanoma. Our approach may improve first-and second-line therapy selection assessments for precision medicine by providing rapid, non-destructive prediction of therapeutic response based on cellular spectral profiles. Context SummaryO_ST_ABSKey objectiveC_ST_ABSCan label-free, single-cell Raman spectroscopy and machine learning approach accurately profile melanoma cell states and therapeutic resistance likelihood to targeted and immunotherapeutic agents? Knowledge generatedRaman spectroscopy with machine learning differentiated tumor microenvironment cell types and functional phenotypes with >96% accuracy in cell lines. When applied to patient-derived metastatic melanoma samples, the approach correctly inferred patient response to a panel of targeted and immunotherapeutic inhibitors with 91% accuracy (30 of 33 cases). High-likelihood persistent and sensitive cells across diverse patients exhibited recurrent spectral features. RelevanceSingle-cell Raman-based profiling supports functional-diagnostic assessment or resistance likelihood and may contribute to improved therapeutic selection and precision oncology strategies for melanoma patients.