A Multimodal Neural Network Model for Early Recurrence Prediction in Lung Adenocarcinoma

Lung adenocarcinoma (LUAD), a subtype of non-small cell lung cancer (NSCLC), is the most common primary lung cancer worldwide. Despite advancements in early detection and treatment, up to 39% of patients develop recurrent tumors following complete resection. Currently, no widely available models exist for reliably predicting early recurrence of LUAD, which is a significant prognostic factor of post-recurrence survival. Models leveraging deep learning (DL) techniques have demonstrated notable utility in cancer recurrence prediction, particularly when used in combination with both clinical and genomic data. We developed a DL-based model, P redicting L ung A denocarcinoma recurrence via S elective M ultimodal A ttention ( PLASMA ), to predict early recurrence using clinical, mRNA expression, and mutation data from patients with primary stage I-III LUAD. Trained on The Cancer Genome Atlas (TCGA) dataset, PLASMA outperformed traditional machine learning models in predicting early recurrence in both the TCGA test set and an external validation set (TRACERx Lung), achieving area under the receiver operating characteristic curve (AUROC) scores of 85.0% and 76.5%, respectively. Our results support the potential of multimodal DL for early LUAD recurrence prediction and risk stratification.