A.I and Machine Learning Based Risk Prediction Model to Improve the Clinical Management of Endometrial Cancer.

Regina Elena Cancer Institute

Status: Enrolling

Conditions: Endometrium Cancer

Study type: Observational

Funder types: Other

Identifiers

NCT06841653

RS203/IRE/24

Details and patient eligibility

About

Prediction of preoperative endometrial biopsy: the evolution from hyperplasia to cancer, the prognosis and the risk of recurrence. Intelligence methods artificial risk will be used to redefine the current risk classes including our profile immuno-mutational to provide a more precise characterization and closer to the real prognosis of the patient.

Full description

Identify new risk factors for endometrial cancer, using an integrated multi-omics approach linked to a specific immune pattern (called MOMIMIC score) useful for improving oncology and surgery precision. The aim is to evaluate the predictive value of the MOMIMIC score for early identification of progression from precancerous lesions to endometrial carcinoma, prognosis and relapses, to help the clinician in the decision to treatments. Through the identification during hysteroscopy of the most appropriate site for biopsies targeted endometrials, through an artificial intelligence algorithm applied to the video system hysteroscopic which, by comparing the information from the omics approach and the hysteroscopic image combined with radiogenomic information, it could help the gynecologist in the procedure and provide information on the prognosis through the omics-iconographic profile in order to calculate a preoperative predictive score. Furthermore by modulating the surgical radicality, according to the information obtained, there will be a tendency to preserve fertility in young patients with a low-risk profile (since currently the risk factors are not sufficient to discriminate for a non-treatment radical). This will help the surgeon through an artificial intelligence algorithm applied to the system robotic/laparoscopic video, will guide the operator in decision-making procedures regarding the resection margins tumor, metastasis localization, pathological lymph node detection, and imaging driven by biomolecular information.

Enrollment: 40 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age > 18 years;
• Histological diagnosis of endometrial hyperplasia, endometrioid adenocarcinoma of the endometrium, healthy endometrium in patients undergoing total hysterectomy for benign extra-endometrial disease;
• Written informed consent (to the study and data processing), for the party's patients only prospective and/or in follow-up) For the retrospective cohort: availability of samples adequately stored at the biobank of the Institute and availability of data relating to follow-up (at least 2 years)

Exclusion criteria

All exclusion criteria adopted in the surgical protocols will be applied to the study. In particular:

• Comorbidities not controlled with adequate medical therapy;
• Infections of the endometrial cavity (pyometra);
• Synchronous cancer;
• Neoadjuvant treatments;
• Previous radiotherapy treatments of the pelvic region;
• Hormone therapies.

Trial design

40 participants in 2 patient groups

Retrospective cohort

Description:

Fresh tissue samples stored at -80°C, collected at the Institute's IRE Biobank (a starting from 2019) and tissue preserved in paraffin at the biobank at 4°C at the UOC Pathological Anatomy archive, for carrying out WES, RNA-seq, scRNA-seq, spatial transcriptomics, metabolomics, proteomics, digital pathology, immune infiltrate characterization (e.g. FACS, immunohistochemistry)

Prospective cohort

Description:

Collection of tissue samples obtained at the time of surgery and verified by the anatomical pathologist for the actual availability and adequacy, for the purpose of the creation of organoids (Patient-Derived Organoids, PDO), cell lines and co-cultures (created with the patient's own peripheral immune cells, collected and processed), in the context of which secretomics analyzes will be conducted using Olink and Luminex.