Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology

Abstract Determining tumor microsatellite status has significant clinical value because tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) respond well to immune checkpoint inhibitors (ICIs) and oftentimes not to chemotherapeutics. We propose MSI-SEER, a deep...

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Main Authors: Sunho Park, Morgan F. Pettigrew, Yoon Jin Cha, In-Ho Kim, Minji Kim, Imon Banerjee, Isabel Barnfather, Jean R. Clemenceau, Inyeop Jang, Hyunki Kim, Younghoon Kim, Rish K. Pai, Jeong Hwan Park, N. Jewel Samadder, Kyo Young Song, Ji-Youn Sung, Jae-Ho Cheong, Jeonghyun Kang, Sung Hak Lee, Sam C. Wang, Tae Hyun Hwang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01580-8
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author Sunho Park
Morgan F. Pettigrew
Yoon Jin Cha
In-Ho Kim
Minji Kim
Imon Banerjee
Isabel Barnfather
Jean R. Clemenceau
Inyeop Jang
Hyunki Kim
Younghoon Kim
Rish K. Pai
Jeong Hwan Park
N. Jewel Samadder
Kyo Young Song
Ji-Youn Sung
Jae-Ho Cheong
Jeonghyun Kang
Sung Hak Lee
Sam C. Wang
Tae Hyun Hwang
author_facet Sunho Park
Morgan F. Pettigrew
Yoon Jin Cha
In-Ho Kim
Minji Kim
Imon Banerjee
Isabel Barnfather
Jean R. Clemenceau
Inyeop Jang
Hyunki Kim
Younghoon Kim
Rish K. Pai
Jeong Hwan Park
N. Jewel Samadder
Kyo Young Song
Ji-Youn Sung
Jae-Ho Cheong
Jeonghyun Kang
Sung Hak Lee
Sam C. Wang
Tae Hyun Hwang
author_sort Sunho Park
collection DOAJ
description Abstract Determining tumor microsatellite status has significant clinical value because tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) respond well to immune checkpoint inhibitors (ICIs) and oftentimes not to chemotherapeutics. We propose MSI-SEER, a deep Gaussian process-based Bayesian model that analyzes H&E whole-slide images in weakly-supervised-learning to predict microsatellite status in gastric and colorectal cancers. We performed extensive validation using multiple large datasets comprised of patients from diverse racial backgrounds. MSI-SEER achieved state-of-the-art performance with MSI prediction by integrating uncertainty prediction. We achieved high accuracy for predicting ICI responsiveness by combining tumor MSI status with stroma-to-tumor ratio. Finally, MSI-SEER’s tile-level predictions revealed novel insights into the role of spatial distribution of MSI-H regions in the tumor microenvironment and ICI response.
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spelling doaj-art-3e9aca173f5f43b69259150733c4a1d22025-08-20T03:08:44ZengNature Portfolionpj Digital Medicine2398-63522025-05-018111510.1038/s41746-025-01580-8Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histologySunho Park0Morgan F. Pettigrew1Yoon Jin Cha2In-Ho Kim3Minji Kim4Imon Banerjee5Isabel Barnfather6Jean R. Clemenceau7Inyeop Jang8Hyunki Kim9Younghoon Kim10Rish K. Pai11Jeong Hwan Park12N. Jewel Samadder13Kyo Young Song14Ji-Youn Sung15Jae-Ho Cheong16Jeonghyun Kang17Sung Hak Lee18Sam C. Wang19Tae Hyun Hwang20Vanderbilt University Medical CenterDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical CenterDepartment of Pathology, Gangnam Severance Hospital, Yonsei University College of MedicineDepartment of Internal Medicine, Division of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaVanderbilt University Medical CenterDepartment of Radiology, Mayo ClinicDepartment of Artificial Intelligence and Informatics, Mayo ClinicVanderbilt University Medical CenterVanderbilt University Medical CenterDepartment of Pathology, Yonsei University College of MedicineDepartment of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Laboratory Medicine and Pathology, Mayo ClinicDepartment of Pathology, SMG-SNU Boramae Medical Center, Seoul National University College of MedicineDepartment of Gastroenterology and Hepatology, Mayo ClinicDivision of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Pathology, College of Medicine, Kyung Hee University hospital, Kyung Hee UniversityDepartment of Surgery, Department of Biochemistry and Molecular Biology, Department of Biomedical Systems Informatics, Yonsei University College of MedicineDepartment of Surgery, Gangnam Severance Hospital, Yonsei University College of MedicineDepartment of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical CenterVanderbilt University Medical CenterAbstract Determining tumor microsatellite status has significant clinical value because tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) respond well to immune checkpoint inhibitors (ICIs) and oftentimes not to chemotherapeutics. We propose MSI-SEER, a deep Gaussian process-based Bayesian model that analyzes H&E whole-slide images in weakly-supervised-learning to predict microsatellite status in gastric and colorectal cancers. We performed extensive validation using multiple large datasets comprised of patients from diverse racial backgrounds. MSI-SEER achieved state-of-the-art performance with MSI prediction by integrating uncertainty prediction. We achieved high accuracy for predicting ICI responsiveness by combining tumor MSI status with stroma-to-tumor ratio. Finally, MSI-SEER’s tile-level predictions revealed novel insights into the role of spatial distribution of MSI-H regions in the tumor microenvironment and ICI response.https://doi.org/10.1038/s41746-025-01580-8
spellingShingle Sunho Park
Morgan F. Pettigrew
Yoon Jin Cha
In-Ho Kim
Minji Kim
Imon Banerjee
Isabel Barnfather
Jean R. Clemenceau
Inyeop Jang
Hyunki Kim
Younghoon Kim
Rish K. Pai
Jeong Hwan Park
N. Jewel Samadder
Kyo Young Song
Ji-Youn Sung
Jae-Ho Cheong
Jeonghyun Kang
Sung Hak Lee
Sam C. Wang
Tae Hyun Hwang
Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
npj Digital Medicine
title Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
title_full Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
title_fullStr Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
title_full_unstemmed Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
title_short Deep Gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
title_sort deep gaussian process with uncertainty estimation for microsatellite instability and immunotherapy response prediction from histology
url https://doi.org/10.1038/s41746-025-01580-8
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