Search PubMed⌕ Search

Biomedical subjects

Shuangge Ma

Publications and source records attributed to Shuangge Ma.

15 recordsLinked to original sources

Matched targeted therapy use after broad genomic profiling in advanced Non-Small cell lung cancer.

INTRODUCTION: While broad genomic profiling is increasingly used in advanced NSCLC (aNSCLC), the impact of test results on subsequent guideline-concordant targeted therapy selection remains incompletely understood. METHODS: Using a merged dataset of two large, nationwide, patient-level databases, we identified patients who were diagnosed with aNSCLC 2017-2023, had potentially actionable genomic profiling findings, and initiated systemic therapy. Patients were categorized into actionability subgroups based on contemporaneous regulatory approvals and NCCN guideline recommendations. Within each subgroup, we assessed receipt of guideline-concordant targeted therapy within 24 months, including potential underuse (non-receipt of recommended treatment) and overuse (receipt of non-recommended treatment). RESULTS: Among 6620 patients (67.4% ≥65 years, 54.6% female, 68.9% White), guideline-concordant targeted therapy use varied substantially by actionability category: 2313 (89.6%) of 2582 patients with available 1st-line on-label options received them (10.4% underuse), while 212 (67.3%) of 315 patients with available later-line on-label options received them after 1st-line (32.7% underuse). Among 441 patients with available guideline-concordant off-label options, only 122 (27.7%) received them (72.3% underuse). Conversely, 238 (8.6%) of 3282 patients received matched but guideline-discordant off-label options, representing overuse of ineffective or unestablished therapies. Smoking history, squamous histology, and high PD-L1 expression were associated with lower targeted therapy receipt. CONCLUSIONS: In this cohort study of aNSCLC care, the guideline concordance of targeted therapy use varied by clinical actionability of molecular testing results. Underuse was more common in patients with later-line and off-label targeted therapy options. Patients with classical smoking-related risk profiles were substantially less likely to receive targeted therapy even when actionable alterations were identified.

Journal Article↗

Gene-Temperature Interactions and Risk of Childhood Acute Lymphoblastic Leukemia.

BACKGROUND: High ambient temperature in early pregnancy has been linked to an increased risk of childhood acute lymphoblastic leukemia (ALL). To better understand biological mechanisms, the current study evaluated potential interaction between temperature and genetic characteristics. METHODS: We used data from California birth records (1982-2008) and California Cancer Registry (1988-2011) to identify ALL cases (n=3,353) diagnosed &#x2264;14 years of age and non-cancer controls (n=3,530) matched 1:1 on sex, race, ethnicity, and birth year and month. Weekly ambient temperatures throughout pregnancy were assessed on a 1-km grid around the birth address, while genetic data were available from a genome-wide association study using neonatal blood spots. We evaluated the association between ambient temperature and ALL risk by quartiles of established genetic risk score for ALL. Next, we formally tested gene-temperature interactions in the association with ALL, correcting for multiple testing, for genes previously identified with epigenetic changes due to both temperature and ALL. All analyses were adjusted for potential confounders. RESULTS: The elevated risk of ALL per 5 &#xb0;C increase of weekly mean ambient temperature, confined to early pregnancy, was more pronounced among children with the lowest genetic susceptibility to ALL, especially among Latino children (first quartile: odds ratio [OR] = 1.50, 95% confidence interval [CI]: 1.14-1.97); fourth quartile: OR=1.03, 95% CI: 0.83-1.28). There were significant interactions (p<0.002) between ambient temperature and polymorphisms in BNC1 among non-Latino White children, and suggestive interactions (p<0.05) with TBPL2 and NRXN1 in the full population. CONCLUSIONS: Our findings suggest that there may be interactions between ambient temperature in early pregnancy and offspring genotype in the risk of childhood ALL. IMPACT: If replicated, these findings could help elucidate the biological mechanisms linking high ambient temperature in early pregnancy and the risk of childhood ALL.

Journal Article↗

Incorporating prior information in gene expression network-based cancer heterogeneity analysis.

Cancer is molecularly heterogeneous, with seemingly similar patients having different molecular landscapes and accordingly different clinical behaviors. In recent studies, gene expression networks have been shown as more effective/informative for cancer heterogeneity analysis than some simpler measures. Gene interconnections can be classified as "direct" and "indirect," where the latter can be caused by shared genomic regulators (such as transcription factors, microRNAs, and other regulatory molecules) and other mechanisms. It has been suggested that incorporating the regulators of gene expressions in network analysis and focusing on the direct interconnections can lead to a deeper understanding of the more essential gene interconnections. Such analysis can be seriously challenged by the large number of parameters (jointly caused by network analysis, incorporation of regulators, and heterogeneity) and often weak signals. To effectively tackle this problem, we propose incorporating prior information contained in the published literature. A key challenge is that such prior information can be partial or even wrong. We develop a two-step procedure that can flexibly accommodate different levels of prior information quality. Simulation demonstrates the effectiveness of the proposed approach and its superiority over relevant competitors. In the analysis of a breast cancer dataset, findings different from the alternatives are made, and the identified sample subgroups have important clinical differences.

Humans↗

GE-IA-NAM: gene-environment interaction analysis via imaging-assisted neural additive model.

MOTIVATION: Gene-environment (G-E) interaction analysis is crucial in cancer research, offering insights into how genetic and environmental factors jointly influence cancer outcomes. Most existing G-E interaction methods are regression-based, which may lack flexibility to capture complex data patterns. Recent advances have investigated deep neural network-based G-E models. However, these methods may be more vulnerable to information deficiency due to challenges such as limited sample size and high dimensionality. Apart from genetic and environmental data, pathological images have emerged as a widely accessible and informative resource for cancer modeling, presenting its potential to enhance G-E modeling. RESULTS: We propose the pathological imaging-assisted neural additive model for G-E analysis (GE-IA-NAM). The flexible and interpretable additive network architecture is adopted to account for individualized effects associated with genetic factors, environmental factors, and their interactions. To improve G-E modeling, an assisted-learning strategy is investigated, which adopts a joint analysis to integrate information from pathological images. Simulations and the analysis of lung and skin cancer datasets from The Cancer Genome Atlas demonstrate the competitive performance of the proposed method. AVAILABILITY AND IMPLEMENTATION: Python code implementing the proposed method is available at https://github.com/Mr-maoge/NAM-IA-GE. The data that support the findings in this article are openly available in TCGA (The Cancer Genome Atlas) at https://portal.gdc.cancer.gov/.

Gene-Environment Interaction↗

Hierarchical Multi-Label Classification With Gene-Environment Interactions in Disease Modeling.

In biomedical studies, gene-environment (G-E) interactions have been demonstrated to have important implications for analyzing disease outcomes beyond the main G and main E effects. Many approaches have been developed for G-E interaction analysis, yielding important findings. However, hierarchical multi-label classification, which provides insightful information on disease outcomes, remains unexplored in G-E analysis literature. Moreover, unlabeled data are commonly observed in practical settings but omitted by many existing methods of hierarchical multi-label classification. In this study, we consider a semi-supervised scenario and develop a novel approach for the two-layer hierarchical response with G-E interactions. A two-step penalized estimation is then proposed using an efficient expectation-maximization (EM) algorithm. Simulation shows that it has superior performance in classification and feature selection. The analysis of The Cancer Genome Atlas (TCGA) data on lung cancer demonstrates the practical utility of the proposed method. Overall, this study can fill the important knowledge gap in G-E interaction analysis by providing a widely applicable framework for hierarchical multi-label classification of complex disease outcomes.

Humans↗

Bayesian Modeling of Cancer Outcomes Using Genetic Variables Assisted by Pathological Imaging Data.

With the increasing maturity of genetic profiling, an essential and routine task in cancer research is to model disease outcomes/phenotypes using genetic variables. Many methods have been successfully developed. However, oftentimes, empirical performance is unsatisfactory because of a "lack of information." In cancer research and clinical practice, a source of information that is broadly available and highly cost-effective comes from pathological images, which are routinely collected for definitive diagnosis and staging. In this article, we consider a Bayesian approach for selecting relevant genetic variables and modeling their relationships with a cancer outcome/phenotype. We propose borrowing information from (manually curated, low-dimensional) pathological imaging features via reinforcing the same selection results for the cancer outcome and imaging features. We further develop a weighting strategy to accommodate the scenario where information borrowing may not be equally effective for all subjects. Computation is carefully examined. Simulations demonstrate competitive performance of the proposed approach. We analyze TCGA (The Cancer Genome Atlas) LUAD (lung adenocarcinoma) data, with overall survival and gene expressions being the outcome and genetic variables, respectively. Findings different from the alternatives and with sound properties are made.

Humans↗

Clustering threshold gradient descent regularization: with applications to microarray studies.

MOTIVATION: An important goal of microarray studies is to discover genes that are associated with clinical outcomes, such as disease status and patient survival. While a typical experiment surveys gene expressions on a global scale, there may be only a small number of genes that have significant influence on a clinical outcome. Moreover, expression data have cluster structures and the genes within a cluster have correlated expressions and coordinated functions, but the effects of individual genes in the same cluster may be different. Accordingly, we seek to build statistical models with the following properties. First, the model is sparse in the sense that only a subset of the parameter vector is non-zero. Second, the cluster structures of gene expressions are properly accounted for. RESULTS: For gene expression data without pathway information, we divide genes into clusters using commonly used methods, such as K-means or hierarchical approaches. The optimal number of clusters is determined using the Gap statistic. We propose a clustering threshold gradient descent regularization (CTGDR) method, for simultaneous cluster selection and within cluster gene selection. We apply this method to binary classification and censored survival analysis. Compared to the standard TGDR and other regularization methods, the CTGDR takes into account the cluster structure and carries out feature selection at both the cluster level and within-cluster gene level. We demonstrate the CTGDR on two studies of cancer classification and two studies correlating survival of lymphoma patients with microarray expressions. AVAILABILITY: R code is available upon request. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Algorithms↗

Empirical study of supervised gene screening.

BACKGROUND: Microarray studies provide a way of linking variations of phenotypes with their genetic causations. Constructing predictive models using high dimensional microarray measurements usually consists of three steps: (1) unsupervised gene screening; (2) supervised gene screening; and (3) statistical model building. Supervised gene screening based on marginal gene ranking is commonly used to reduce the number of genes in the model building. Various simple statistics, such as t-statistic or signal to noise ratio, have been used to rank genes in the supervised screening. Despite of its extensive usage, statistical study of supervised gene screening remains scarce. Our study is partly motivated by the differences in gene discovery results caused by using different supervised gene screening methods. RESULTS: We investigate concordance and reproducibility of supervised gene screening based on eight commonly used marginal statistics. Concordance is assessed by the relative fractions of overlaps between top ranked genes screened using different marginal statistics. We propose a Bootstrap Reproducibility Index, which measures reproducibility of individual genes under the supervised screening. Empirical studies are based on four public microarray data. We consider the cases where the top 20%, 40% and 60% genes are screened. CONCLUSION: From a gene discovery point of view, the effect of supervised gene screening based on different marginal statistics cannot be ignored. Empirical studies show that (1) genes passed different supervised screenings may be considerably different; (2) concordance may vary, depending on the underlying data structure and percentage of selected genes; (3) evaluated with the Bootstrap Reproducibility Index, genes passed supervised screenings are only moderately reproducible; and (4) concordance cannot be improved by supervised screening based on reproducibility.

Artificial Intelligence↗

Regularized binormal ROC method in disease classification using microarray data.

BACKGROUND: An important application of microarrays is to discover genomic biomarkers, among tens of thousands of genes assayed, for disease diagnosis and prognosis. Thus it is of interest to develop efficient statistical methods that can simultaneously identify important biomarkers from such high-throughput genomic data and construct appropriate classification rules. It is also of interest to develop methods for evaluation of classification performance and ranking of identified biomarkers. RESULTS: The ROC (receiver operating characteristic) technique has been widely used in disease classification with low dimensional biomarkers. Compared with the empirical ROC approach, the binormal ROC is computationally more affordable and robust in small sample size cases. We propose using the binormal AUC (area under the ROC curve) as the objective function for two-sample classification, and the scaled threshold gradient directed regularization method for regularized estimation and biomarker selection. Tuning parameter selection is based on V-fold cross validation. We develop Monte Carlo based methods for evaluating the stability of individual biomarkers and overall prediction performance. Extensive simulation studies show that the proposed approach can generate parsimonious models with excellent classification and prediction performance, under most simulated scenarios including model mis-specification. Application of the method to two cancer studies shows that the identified genes are reasonably stable with satisfactory prediction performance and biologically sound implications. The overall classification performance is satisfactory, with small classification errors and large AUCs. CONCLUSION: In comparison to existing methods, the proposed approach is computationally more affordable without losing the optimality possessed by the standard ROC method.

Biomarkers, Tumor↗

A semiparametric approach for the nonparametric transformation survival model with multiple covariates.

The nonparametric transformation model makes no parametric assumptions on the forms of the transformation function and the error distribution. This model is appealing in its flexibility for modeling censored survival data. Current approaches for estimation of the regression parameters involve maximizing discontinuous objective functions, which are numerically infeasible to implement with multiple covariates. Based on the partial rank (PR) estimator (Khan and Tamer, 2004), we propose a smoothed PR estimator which maximizes a smooth approximation of the PR objective function. The estimator is shown to be asymptotically equivalent to the PR estimator but is much easier to compute when there are multiple covariates. We further propose using the weighted bootstrap, which is more stable than the usual sandwich technique with smoothing parameters, for estimating the standard error. The estimator is evaluated via simulation studies and illustrated with the Veterans Administration lung cancer data set.

Antineoplastic Agents↗

Multiple augmentation with partial missing regressors.

In large cohort studies, it is common that a subset of the regressors may be missing for some study subjects by design or happenstance. In this article, we apply the multiple data augmentation techniques to semiparametric models for epidemiologic data when a subset of the regressors are missing for some subjects, under the assumption that the data are missing at random in the sense of Rubin (2004) and that the missingness probabilities depend jointly on the observable subset of regressors, on a set of observable extraneous variables and on the outcome. Computational algorithms for the Poor Man's and the Asymptotic Normal data augmentations are investigated. Simulation studies show that the data augmentation approach generates satisfactory estimates and is computationally affordable. Under certain simulation scenarios, the proposed approach can achieve asymptotic efficiency similar to the maximum likelihood approach. We apply the proposed technique to the Multi-Ethic Study of Atherosclerosis (MESA) data and the South Wales Nickel Worker Study data.

Algorithms↗

Additive risk models for survival data with high-dimensional covariates.

As a useful alternative to Cox's proportional hazard model, the additive risk model assumes that the hazard function is the sum of the baseline hazard function and the regression function of covariates. This article is concerned with estimation and prediction for the additive risk models with right censored survival data, especially when the dimension of the covariates is comparable to or larger than the sample size. Principal component regression is proposed to give unique and numerically stable estimators. Asymptotic properties of the proposed estimators, component selection based on the weighted bootstrap, and model evaluation techniques are discussed. This approach is illustrated with analysis of the primary biliary cirrhosis clinical data and the diffuse large B-cell lymphoma genomic data. It is shown that this methodology is numerically stable and effective in dimension reduction, while still being able to provide satisfactory prediction and classification results.

Humans↗

Robust semiparametric microarray normalization and significance analysis.

Microarray technology allows the monitoring of expression levels of thousands of genes simultaneously. A semiparametric location and scale model is proposed to model gene expression levels for normalization and significance analysis purposes. Robust estimation based on weighted least absolute deviation regression and significance analysis based on the weighted bootstrap are investigated. The proposed approach naturally combines normalization and significance analysis, and incorporates the variations due to normalization into the significance analysis properly. A small simulation study is used to compare finite sample performance of the proposed approach with alternatives. We also demonstrate the proposed method with a real dataset.

Biometry↗

Regularized estimation in the accelerated failure time model with high-dimensional covariates.

We consider two regularization approaches, the LASSO and the threshold-gradient-directed regularization, for estimation and variable selection in the accelerated failure time model with multiple covariates based on Stute's weighted least squares method. The Stute estimator uses Kaplan-Meier weights to account for censoring in the least squares criterion. The weighted least squares objective function makes the adaptation of this approach to multiple covariate settings computationally feasible. We use V-fold cross-validation and a modified Akaike's Information Criterion for tuning parameter selection, and a bootstrap approach for variance estimation. The proposed method is evaluated using simulations and demonstrated on a real data example.

Algorithms↗

Regularized ROC method for disease classification and biomarker selection with microarray data.

MOTIVATION: An important application of microarrays is to discover genomic biomarkers, among tens of thousands of genes assayed, for disease classification. Thus there is a need for developing statistical methods that can efficiently use such high-throughput genomic data, select biomarkers with discriminant power and construct classification rules. The ROC (receiver operator characteristic) technique has been widely used in disease classification with low-dimensional biomarkers because (1) it does not assume a parametric form of the class probability as required for example in the logistic regression method; (2) it accommodates case-control designs and (3) it allows treating false positives and false negatives differently. However, due to computational difficulties, the ROC-based classification has not been used with microarray data. Moreover, the standard ROC technique does not incorporate built-in biomarker selection. RESULTS: We propose a novel method for biomarker selection and classification using the ROC technique for microarray data. The proposed method uses a sigmoid approximation to the area under the ROC curve as the objective function for classification and the threshold gradient descent regularization method for estimation and biomarker selection. Tuning parameter selection based on the V-fold cross validation and predictive performance evaluation are also investigated. The proposed approach is demonstrated with a simulation study, the Colon data and the Estrogen data. The proposed approach yields parsimonious models with excellent classification performance.

Algorithms↗