Treatment response-adapted risk index model for survival prediction and adjuvant chemotherapy selection in nonmetastatic nasopharyngeal carcinoma

Dynamic response to therapy is strongly associated with cancer outcomes. We aim to develop the response-adapted individualized risk index (RAIRI) as an individual prognostic approach and predictive biomarker for adjuvant chemotherapy (AC) benefit in nasopharyngeal carcinoma (NPC) based on pretreatment clinical characteristics, longitudinal cell-free Epstein-Barr virus DNA, and MRI-based tumor regression measurements collected during treatment. Using Bayesian joint model, we developed and validated RAIRI, a dynamic and multidimensional model, with 2148 patients in training, internal validation, external validation, and RCT cohorts (ClinicalTrials.gov NCT02958111 2016-11-04 and NCT02143388 2014-05-18). RAIRI predictions were refined over time using serially collected longitudinal data. RAIRI demonstrated accurate calibration and high prognostic accuracy, superior to conventional models. In RCT cohort, RAIRI identified approximately 70% of low-risk patients who did not benefit from AC, whereas the high-risks experienced substantial benefits from AC. Therefore, RAIRI could provide real-time updated quantitative survival estimates for individuals and facilitate personalized AC selection.

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Publication Details

Journal
npj Digital Medicine
Published
2025-09-01
DOI
https://doi.org/10.1038/s41746-025-01918-2
Primary Topic
Head and Neck Cancer Studies
Type
article
Field-Weighted Citation Impact
0.00

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article

Treatment response-adapted risk index model for survival prediction and adjuvant chemotherapy selection in nonmetastatic nasopharyngeal carcinoma

Wenbin Yan, Xuesong Chen, Yu‐Pei Chen, Jun Ma et al.
npj Digital Medicine
Head and Neck Cancer Studies
article

Treatment response-adapted risk index model for survival prediction and adjuvant chemotherapy selection in nonmetastatic nasopharyngeal carcinoma

Wenbin Yan, Xuesong Chen, Yu‐Pei Chen, Jun Ma, Jingwei Luo, Junlin Yi, Ye‐Xiong Li, Runye Wu, Xiaodong Huang, Jingjing Miao, Chong Zhao, Yang Liu, Hua Zhang, Kai Wang, Ye Zhang, Jingbo Wang, Yuan Qu, Jianghu Zhang
article en

Abstract

Dynamic response to therapy is strongly associated with cancer outcomes. We aim to develop the response-adapted individualized risk index (RAIRI) as an individual prognostic approach and predictive biomarker for adjuvant chemotherapy (AC) benefit in nasopharyngeal carcinoma (NPC) based on pretreatment clinical characteristics, longitudinal cell-free Epstein-Barr virus DNA, and MRI-based tumor regression measurements collected during treatment. Using Bayesian joint model, we developed and validated RAIRI, a dynamic and multidimensional model, with 2148 patients in training, internal validation, external validation, and RCT cohorts (ClinicalTrials.gov NCT02958111 2016-11-04 and NCT02143388 2014-05-18). RAIRI predictions were refined over time using serially collected longitudinal data. RAIRI demonstrated accurate calibration and high prognostic accuracy, superior to conventional models. In RCT cohort, RAIRI identified approximately 70% of low-risk patients who did not benefit from AC, whereas the high-risks experienced substantial benefits from AC. Therefore, RAIRI could provide real-time updated quantitative survival estimates for individuals and facilitate personalized AC selection.

npj Digital MedicineVol. 8(1)
Sun Yat-sen University (CN), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Peking University (CN), National Cancer Center (US), Fudan University Shanghai Cancer Center (CN), Cancer Hospital of Chinese Academy of Medical Sciences (CN), Peking University Third Hospital (CN), Sun Yat-sen University Cancer Center (CN)
National Natural Science Foundation of China, Chinese Academy of Medical Sciences
Openalex Percentile: Top 69%
Head and Neck Cancer Studies
DOIOpen Access PDFOpenAlex
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