Turing AI Fellowship: clinAIcan - developing clinical applications of artificial intelligence for cancer

Lead Research Organisation: University of Oxford
Department Name: Women s and Reproductive Health

Abstract

Cancer is an evolving disease. No two cancers are ever exactly the same, no two cancer cells are even likely to be the same at the molecular level. 'Omics technologies allow us to measure the molecular activity of cancer to determine how it changes as the cancer develops. However, this is difficult to do with real patients as we only ever have access to a cancer only when it has developed and, once diagnosed, the cancer will be treated, perturbing it from its natural untreated trajectory. It is never possible to directly measure what the cancer was like before diagnosis, in its earliest stages of development, nor what would happen to the cancer if it was untreated or treated in a different way.

In this project, we aim to develop artificial intelligence (AI) technologies that will allow us to describe how cancers evolve at the molecular level. We exploit the fact that cancer, whilst never exactly identical, they often share similar development trajectories which we can learn by collating information from across deep high-resolution molecular profiles of many cancers. As patients will never be diagnosed at exactly the same point of disease progression, each patient therefore occupies a unique point on the common disease trajectory. A collection of patients therefore should represent a continuum along these trajectories. AI can therefore help us to understand how cancers change over time by leveraging information from across many patients without us having to actually follow and observe cancers as they develop in individual patients.

In this research, we will develop models of cancer progression using a rich-body of modern AI techniques that we will make novel adaptations to enable their application to 'omics data. We will then use these technologies and work with a range of academic, industry and charity partners to identify prototypic applications of this research that might including helping to improve treatment decision making for cancer, provide patients with more detailed information about their disease and treatment options in an accessible way and to improve the efficiency and efficacy of cancer clinical trials.

Publications

10 25 50
 
Description We have successfully worked with the biotechnology start-up Singula Bio to develop a new analysis tool (called "PicoCNV") to identify DNA changes in microscopic cancer samples from whole genome sequencing. Microscopic cancer samples contain very few cells and frequently appear after cancer treatment. These cells are often treatment resistant and can go on to produce secondary cancers. At the microscopic stage they do not contain sufficient DNA to allow conventional DNA sequencing. Singula Bio have overcome this by developing a new sequencing platform which - together with our analysis algorithm - allows accurate determination of DNA changes in the cancer cells. These DNA changes are being used by Singula Bio to help them design individualised cancer immunotherapies.

The flexibility of this fellowship has also allowed my team to make a significant contribution to the MUM-PREDICT project (https://mumpredict.org/) where we have developed AI tools to identify patterns of multiple long-term conditions in women with pregnancy. Our tools have enabled us to identify rare combinations of conditions which co-occur in pregnant women from large GP databases. We have also developed risk prediction tools that allow us to predict the next most likely health condition an individual based on their current health status. Our contribution has been recognised by Health Data Research UK, where we were awarded "Team of the Year" in 2022 as part of the wider MUM-PREDICT research collaboration. Recently we successfully applied for further EPSRC funding to develop a foundation model for clinical prediction of multiple long-term conditions using millions of GP health records.
Exploitation Route We are currently working with public health specialists and clinicians linked to the MUM-PREDICT project to understand how our risk prediction tools can be deployed for real world use to support pregnancy in the community.

We have filed a patent with Singula Bio for PicoCNV. This software is currently incorporated into Singula Bio's research and development for cancer immunotherapies.
Sectors Healthcare

URL https://mumpredict.org/a-winning-end-to-2022/
 
Description We have contributed to the development of the Physiological Society report From 'Black Box' to Trusted Healthcare Tools which looks at physiology's role in unlocking the potential of artificial intelligence for health. The report launched in the Houses of Lords on 27 June 2023. My work on Ovarian Cancer was a highlighted case example. https://www.physoc.org/policy/public-health-and-ageing/aiphysiology/ https://www.physoc.org/magazine-articles/editorial-28/
First Year Of Impact 2023
Sector Healthcare,Pharmaceuticals and Medical Biotechnology
Impact Types Policy & public services

 
Description Clinical prediction foundation models for individuals with multiple long-term conditions
Amount £615,516 (GBP)
Funding ID EP/Y018192/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 09/2023 
End 04/2025
 
Description MHRA TIGER 
Organisation Medicines and Healthcare Regulatory Agency
Country United Kingdom 
Sector Public 
PI Contribution We are providing expert advice and developing guidance to the MHRA for the development of Software and AI as a Medical Device.
Collaborator Contribution MHRA are leading this Software and AI as a Medical Device Change Programme as the regulator for this area.
Impact Outputs will appear in late 2023.
Start Year 2022
 
Description Roche 
Organisation F. Hoffmann-La Roche AG
Department Roche Diagnostics
Country Global 
Sector Private 
PI Contribution We have co-developed with Roche two training events (based on a hackathon format) for doctoral students in spatial biology and protein modelling informatics. The first was held in July 2023 and the second will be in April 2024.
Collaborator Contribution Roche have co-funded the events and provided expert knowledge in the design and setup of the workshops. They are also offering internships to selected participants at the training events.
Impact N/A
Start Year 2023
 
Title DeSurv 
Description Derivative-Based Neural Modelling of Cumulative Distribution Functions for Survival Analysis 
Type Of Technology Software 
Year Produced 2022 
Open Source License? Yes  
Impact Research led to successful follow-up grant applications. 
URL https://github.com/djdanks/DeSurv
 
Title Rarity 
Description This repository provides an implementation of Rarity, a hybrid clustering framework with the goal to identify potentially novel rare clusters of cells from single cell image mass cytometry data. 
Type Of Technology Software 
Year Produced 2023 
Open Source License? Yes  
Impact None yet as only recently released. 
URL https://github.com/kasparmartens/rarity
 
Description 2nd Annual World Ovarian Cancer Coalition Global Partner Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact As part of the World Ovarian Cancer Coalition Partner meeting, I contributed to an online discussion session on "Cancer Research: Innovation and Technology" with Mike Ambrogi, Kathrin Felkendt. The purpose was to introduce the audience to the every day work that scientists and researchers do to change the future of ovarian cancer. At this session we chat with experts on their out-of-the-box work in cancer research, their innovations, and the potential for technology. First aired at 2nd Annual World Ovarian Cancer Coalition Global Partner Meeting, November 30, 2022.
Year(s) Of Engagement Activity 2022
URL https://www.youtube.com/watch?v=sI4oXIm3ZKs&ab_channel=WorldOvarianCancerCoalition