i-Biomarker CaDx: A circulating miRNA-based multi-cancer detection test with generative and explainable AI for colorectal cancer.

64 Background: Colorectal cancer (CRC), the second most deadly cancer, underscores the critical need for early detection to significantly improve treatment outcomes and survival rates. Colonoscopy, flexible sigmoidoscopy, and the fecal immunochemical tests (FIT), often fail to capture early disease, significantly decreasing the survival chance. Circulating miRNA is a promising non-invasive biomarker for various cancers, including CRC. The i-Biomarker CaDx (patent pending) is an innovative multi-cancer early detection and diagnosis platform, covering 32 cancer types with an impressive accuracy rate of 99-100%. This study focuses on the effectiveness of i-Biomarker CaDx for CRC, employing significant data collection and leveraging insights from Generative AI (GenAI) and Explainable Artificial Intelligence (XAI). Methods: We collected various available datasets (e.g. GSE106817, etc.) encompassing 305 colorectal cancer patients and a matching number of healthy controls. Microarray was employed to profile circulating miRNAs. We used various classification paradigms, e.g., decision trees, neural networks, etc. Hyperparameter optimization was conducted, and the best-performing classifiers were amalgamated in the final model, weighted by their respective efficacies. We assessed i-Biomarker CaDx's performance through cross-validation and independent test sets. The XAI provided detailed insights into miRNA variations associated with personalized diagnostic. GenAI integrated the test into the screening and early detection best practice workflows and performs Functional Analysis. Results: i-Biomarker CaDx shows exceptional diagnostic accuracy of 99-100%, surpassing conventional colorectal cancer diagnostic methods like colonoscopy, flexible sigmoidoscopy, and FIT. It can also be used for personalized treatment response monitoring. I-Biomarker effectively deciphers intricate miRNA relationships relevant to colorectal cancer using XAI. Thus, our analyses shed light on miRNA patterns and their associations with colorectal cancer, enhancing the understanding of the underlying molecular complexities of the disease. It goes further by explaining the personalized cellular and molecular mechanisms involved, and it will be integrated into the corresponding medical workflows. Conclusions: Our AI-powered multi-cancer early diagnostic platform demonstrates outstanding performance in detecting CRC, surpassing traditional diagnostic methods like colonoscopy, flexible sigmoidoscopy, and FIT. XAI allows for in-depth exploration of miRNA alterations and their impact on CRC, enriching our interpretations at both the population and individual levels. These findings underscore the substantial potential of i-Biomarker CaDx as a transformative, non-invasive diagnostic tool for CRC.