A Machine Learning Model Optimized for Local Data Stratifies Patients for the Adoptive Cell Therapy with Tumor Infiltrating Lymphocytes in Bladder Tumors

Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TIL) is a form of personalized immunotherapy that requires ex vivo expansion of autologous TILs and their reinfusion back into the patient. Predicting TIL expansion at the time of diagnosis may improve selection of patients that can benefit from ACT-TIL. It can also prevent high treatment-related costs and delays in treatment of patients whose cancer specimens would not yield successful TIL growth. We developed PETIL, a machine-learning model optimized for data of a medium size to determine a minimal combination of features (demographic, clinical, and biological specimen-based) that is predictive of expansion of TILs from a resected bladder cancer. We used a retrospectively identified set of data from bladder cancer patients at Moffitt Cancer Center for the training and testing cohorts. Additionally, we used data from a recent feasibility clinical trial at Moffitt Cancer Center as a blinded validation cohort. PETIL uses random forest method to identify a combination of robust predictive features, support vector machine model to determine the optimal classification hyperparameters, and Matthews correlation coefficient method to adjust the decision-boundary threshold for imbalanced data. Our model yielded AUC=0.740 for the testing cohort and AUC=0.857 for blinded validation cohort. Thus, our PETIL model optimized for data of medium size has favorable performance metrics for predicting TIL expansion from a given tumor. Authors SummaryTreatment with autologous tumor-infiltrating lymphocytes (TIL) that are expanded ex vivo from a given tumor and then reinfused into the patient is a promising personalized immunotherapy. However, the TIL expansion takes about 4-6 weeks, thus developing tools that predict whether TIL growth will be successful can help to avoid delays in treatment of patients whose cancer specimens would not yield successful TIL expansion. Our Predictor of Expansion of TIL (PETIL) is a machine-learning model that uses patients demographic information, clinical tumor classification, and biological tumor specimen-based measurements to determine a minimal set of these data features that are predictive of TIL expansion outcome. We applied this model to data from bladder cancer patients collected at Moffitt Cancer Center and showed that PETIL has favorable performance metrics for the dataset of a moderate size. This computational predictor can support clinicians in determining which patients are candidates for TIL immunotherapy. The developed PETIL pipeline can also be adjusted to data from other solid tumors.