Predicting therapeutic clinical trial enrollment for adult patients with low- and high-grade glioma using supervised machine learning
Therapeutic clinical trial enrollment does not match glioma incidence across demographics. Traditional statistical methods have identified independent predictors of trial enrollment; however, our understanding of the interactions between these factors remains limited. To test the interactive effects of demographic, socioeconomic, and oncologic variables on trial enrollment, we designed boosted neural networks (BNNs) for all glioma patients (<i>n</i> = 1042), women (<i>n</i> = 445, 42.7%), and minorities (<i>n</i> = 151, 14.5%) and externally validated these models [whole cohort, <i>n</i> = 230; women, <i>n</i> = 89 (38.7%); minority, <i>n</i> = 66 (28.7%)]. For the whole-cohort BNN, the most influential variables on enrollment were oncologic variables, including KPS [total effect (TE), 0.327], chemotherapy (TE, 0.326), tumor location (TE, 0.322), and seizures (TE, 0.239). The women-only BNN exhibited a similar trend. Conversely, for the minority-only BNN, socioeconomic variables [insurance status (TE, 0.213), occupation classification (TE, 0.204), and employment status (TE, 0.150)] were most influential. These results may help prioritize patient-specific initiatives to increase accrual.
Authors
- Annick Desjardins (ORCID: https://orcid.org/0000-0003-3869-8283)
- Saritha Krishna
- Ellery Reason (ORCID: https://orcid.org/0009-0004-0922-4446)
- Cesar Nava Gonzales
- Gayathri Warrier (ORCID: https://orcid.org/0000-0002-0716-8012)
- Peter E. Fecci (ORCID: https://orcid.org/0000-0002-2912-8695)
- Annette M. Molinaro (ORCID: https://orcid.org/0000-0002-9854-7404)
- Kimberly Badal (ORCID: https://orcid.org/0000-0001-7776-0831)
- Shawn L. Hervey‐Jumper (ORCID: https://orcid.org/0000-0003-4699-260X)
- Mulki Mehari
- Mikias Negussie (ORCID: https://orcid.org/0000-0001-6060-6926)
- Ugonma Nnenna Chukwueke (ORCID: https://orcid.org/0000-0003-0598-9535)
- Todd Charles Hollon (ORCID: https://orcid.org/0000-0001-5987-6531)
- Andy Daniel (ORCID: https://orcid.org/0000-0002-3871-3685)
- Ann Marie Flusché (ORCID: https://orcid.org/0009-0008-9037-4239)
- Tara Dalton (ORCID: https://orcid.org/0000-0003-4796-6948)
- Aden Haskell-Mendoza (ORCID: https://orcid.org/0000-0002-9186-7261)
- Arushi Tripathy (ORCID: https://orcid.org/0000-0002-5635-6036)
- Alyx B. Porter (ORCID: https://orcid.org/0000-0003-0666-1320)
- Edwin Nieblas‐Bedolla (ORCID: https://orcid.org/0000-0001-5879-1800)
- Vardhaan Sai Ambati (ORCID: https://orcid.org/0000-0003-0074-9217)
- Sheantel Reihl (ORCID: https://orcid.org/0000-0002-5756-6801)
- Joshua Jackson (ORCID: https://orcid.org/0000-0002-9736-2096)
- Rohan Jha
- Susan M. Chang
- Abraham Dada (ORCID: https://orcid.org/0000-0002-2125-7011)
- Aymen Kabir
- Ariel T Gonzalez
Institutions
- Harvard University (US)
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- University of Michigan (US)
- Michigan Medicine (US)
- Dana-Farber Cancer Institute (US)
- Mayo Clinic in Arizona (US)
- Duke Medical Center (US)
- Mayo Clinic Hospital (US)
- Duke University Hospital (US)
- Pediatric Brain Tumor Foundation (US)
- UCSF Helen Diller Family Comprehensive Cancer Center (US)
Publication Details
- Journal
- Science Advances
- Published
- 2025-06-06
- DOI
- https://doi.org/10.1126/sciadv.adt5708
- Citations
- 2
- Primary Topic
- Ethics in Clinical Research
- Type
- article
- Field-Weighted Citation Impact
- 3.76