TrialEnroll: Predicting Clinical Trial Enrollment Success with Deep & Cross Network and Large Language Models

Clinical trials need to recruit a sufficient number of volunteer patients to demonstrate the statistical power of the treatment (e.g., a new drug) in curing a certain disease. Clinical trial recruitment has a significant impact on trial success. Forecasting whether the recruitment process would be successful before we run the trial would save many resources and time. This paper develops a novel deep & cross network with large language model (LLM)-augmented text feature that learns semantic information from trial eligibility criteria and predicts enrollment success. The proposed method enables interpretability by understanding which sentence/word in eligibility criteria contributes heavily to prediction. We also demonstrate the empirical superiority of the proposed method (0.7002 PR-AUC) over a bunch of well-established machine learning methods. The code and curated dataset are publicly available at https://anonymous.4open.science/r/TrialEnroll-7E12.

TrialBench: Multi-Modal Artificial Intelligence-Ready Clinical Trial Datasets

Clinical trials are pivotal for developing new medical treatments, yet they typically pose some risks such as patient mortality, adverse events, and enrollment failure that waste immense efforts spanning over a decade. Applying artificial intelligence (AI) to forecast or simulate key events in clinical trials holds great potential for providing insights to guide trial designs. However, complex data collection and question definition requiring medical expertise and a deep understanding of trial designs have hindered the involvement of AI thus far. This paper tackles these challenges by presenting a comprehensive suite of meticulously curated AIready datasets covering multi-modal data (e.g., drug molecule, disease code, text, categorical/numerical features) and 8 crucial prediction challenges in clinical trial design, encompassing prediction of trial duration, patient dropout rate, serious adverse event, mortality rate, trial approval outcome, trial failure reason, drug dose finding, design of eligibility criteria. Furthermore, we provide basic validation methods for each task to ensure the datasets' usability and reliability. We anticipate that the availability of such open-access datasets will catalyze the development of advanced AI approaches for clinical trial design, ultimately advancing clinical trial research and accelerating medical solution development. The curated dataset, metrics, and basic models are publicly available at https://github.com/ML2Health/ML2ClinicalTrials/tree/main/AI4Trial.

Graph Adversarial Diffusion Convolution

This paper introduces a min-max optimization formulation for the Graph Signal Denoising (GSD) problem. In this formulation, we first maximize the second term of GSD by introducing perturbations to the graph structure based on Laplacian distance and then minimize the overall loss of the GSD. By solving the min-max optimization problem, we derive a new variant of the Graph Diffusion Convolution (GDC) architecture, called Graph Adversarial Diffusion Convolution (GADC). GADC differs from GDC by incorporating an additional term that enhances robustness against adversarial attacks on the graph structure and noise in node features. Moreover, GADC improves the performance of GDC on heterophilic graphs. Extensive experiments demonstrate the effectiveness of GADC across various datasets. Code is available at https://github.com/SongtaoLiu0823/GADC.

Structure-based Drug Design Benchmark: Do 3D Methods Really Dominate?

Currently, the field of structure-based drug design is dominated by three main types of algorithms: search-based algorithms, deep generative models, and reinforcement learning. While existing works have typically focused on comparing models within a single algorithmic category, cross-algorithm comparisons remain scarce. In this paper, to fill the gap, we establish a benchmark to evaluate the performance of sixteen models across these different algorithmic foundations by assessing the pharmaceutical properties of the generated molecules and their docking affinities with specified target proteins. We highlight the unique advantages of each algorithmic approach and offer recommendations for the design of future SBDD models. We emphasize that 1D/2D ligand-centric drug design methods can be used in SBDD by treating the docking function as a black-box oracle, which is typically neglected. The empirical results show that 1D/2D methods achieve competitive performance compared with 3D-based methods that use the 3D structure of the target protein explicitly. Also, AutoGrow4, a 2D molecular graph-based genetic algorithm, dominates SBDD in terms of optimization ability. The relevant code is available in https://github.com/zkysfls/2024-sbdd-benchmark.

drGAT: Attention-Guided Gene Assessment of Drug Response Utilizing a Drug-Cell-Gene Heterogeneous Network

Drug development is a lengthy process with a high failure rate. Increasingly, machine learning is utilized to facilitate the drug development processes. These models aim to enhance our understanding of drug characteristics, including their activity in biological contexts. However, a major challenge in drug response (DR) prediction is model interpretability as it aids in the validation of findings. This is important in biomedicine, where models need to be understandable in comparison with established knowledge of drug interactions with proteins. drGAT, a graph deep learning model, leverages a heterogeneous graph composed of relationships between proteins, cell lines, and drugs. drGAT is designed with two objectives: DR prediction as a binary sensitivity prediction and elucidation of drug mechanism from attention coefficients. drGAT has demonstrated superior performance over existing models, achieving 78\% accuracy (and precision), and 76\% F1 score for 269 DNA-damaging compounds of the NCI60 drug response dataset. To assess the model's interpretability, we conducted a review of drug-gene co-occurrences in Pubmed abstracts in comparison to the top 5 genes with the highest attention coefficients for each drug. We also examined whether known relationships were retained in the model by inspecting the neighborhoods of topoisomerase-related drugs. For example, our model retained TOP1 as a highly weighted predictive feature for irinotecan and topotecan, in addition to other genes that could potentially be regulators of the drugs. Our method can be used to accurately predict sensitivity to drugs and may be useful in the identification of biomarkers relating to the treatment of cancer patients.

Language Interaction Network for Clinical Trial Approval Estimation

Clinical trial outcome prediction seeks to estimate the likelihood that a clinical trial will successfully reach its intended endpoint. This process predominantly involves the development of machine learning models that utilize a variety of data sources such as descriptions of the clinical trials, characteristics of the drug molecules, and specific disease conditions being targeted. Accurate predictions of trial outcomes are crucial for optimizing trial planning and prioritizing investments in a drug portfolio. While previous research has largely concentrated on small-molecule drugs, there is a growing need to focus on biologics-a rapidly expanding category of therapeutic agents that often lack the well-defined molecular properties associated with traditional drugs. Additionally, applying conventional methods like graph neural networks to biologics data proves challenging due to their complex nature. To address these challenges, we introduce the Language Interaction Network (LINT), a novel approach that predicts trial outcomes using only the free-text descriptions of the trials. We have rigorously tested the effectiveness of LINT across three phases of clinical trials, where it achieved ROC-AUC scores of 0.770, 0.740, and 0.748 for phases I, II, and III, respectively, specifically concerning trials involving biologic interventions.

CT-Agent: Clinical Trial Multi-Agent with Large Language Model-based Reasoning

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (CT-Agent), a Clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. Our system autonomously manages the entire clinical trial process, demonstrating significant efficiency improvements in our evaluations, which include both computational benchmarks and expert feedback.

TrialDura: Hierarchical Attention Transformer for Interpretable Clinical Trial Duration Prediction

The clinical trial process, also known as drug development, is an indispensable step toward the development of new treatments. The major objective of interventional clinical trials is to assess the safety and effectiveness of drug-based treatment in treating certain diseases in the human body. However, clinical trials are lengthy, labor-intensive, and costly. The duration of a clinical trial is a crucial factor that influences overall expenses. Therefore, effective management of the timeline of a clinical trial is essential for controlling the budget and maximizing the economic viability of the research. To address this issue, We propose TrialDura, a machine learning-based method that estimates the duration of clinical trials using multimodal data, including disease names, drug molecules, trial phases, and eligibility criteria. Then, we encode them into Bio-BERT embeddings specifically tuned for biomedical contexts to provide a deeper and more relevant semantic understanding of clinical trial data. Finally, the model's hierarchical attention mechanism connects all of the embeddings to capture their interactions and predict clinical trial duration. Our proposed model demonstrated superior performance with a mean absolute error (MAE) of 1.04 years and a root mean square error (RMSE) of 1.39 years compared to the other models, indicating more accurate clinical trial duration prediction. Publicly available code can be found at https://anonymous.4open.science/r/TrialDura-F196

AUTODIFF: Autoregressive Diffusion Modeling for Structure-based Drug Design

Structure-based drug design (SBDD), which aims to generate molecules that can bind tightly to the target protein, is an essential problem in drug discovery, and previous approaches have achieved initial success. However, most existing methods still suffer from invalid local structure or unrealistic conformation issues, which are mainly due to the poor leaning of bond angles or torsional angles. To alleviate these problems, we propose AUTODIFF, a diffusion-based fragment-wise autoregressive generation model. Specifically, we design a novel molecule assembly strategy named conformal motif that preserves the conformation of local structures of molecules first, then we encode the interaction of the protein-ligand complex with an SE(3)-equivariant convolutional network and generate molecules motif-by-motif with diffusion modeling. In addition, we also improve the evaluation framework of SBDD by constraining the molecular weights of the generated molecules in the same range, together with some new metrics, which make the evaluation more fair and practical. Extensive experiments on CrossDocked2020 demonstrate that our approach outperforms the existing models in generating realistic molecules with valid structures and conformations while maintaining high binding affinity.

Multimodal Clinical Trial Outcome Prediction with Large Language Models

The clinical trial is a pivotal and costly process, often spanning multiple years and requiring substantial financial resources. Therefore, the development of clinical trial outcome prediction models aims to exclude drugs likely to fail and holds the potential for significant cost savings. Recent data-driven attempts leverage deep learning methods to integrate multimodal data for predicting clinical trial outcomes. However, these approaches rely on manually designed modal-specific encoders, which limits both the extensibility to adapt new modalities and the ability to discern similar information patterns across different modalities. To address these issues, we propose a multimodal mixture-of-experts (LIFTED) approach for clinical trial outcome prediction. Specifically, LIFTED unifies different modality data by transforming them into natural language descriptions. Then, LIFTED constructs unified noise-resilient encoders to extract information from modal-specific language descriptions. Subsequently, a sparse Mixture-of-Experts framework is employed to further refine the representations, enabling LIFTED to identify similar information patterns across different modalities and extract more consistent representations from those patterns using the same expert model. Finally, a mixture-of-experts module is further employed to dynamically integrate different modality representations for prediction, which gives LIFTED the ability to automatically weigh different modalities and pay more attention to critical information. The experiments demonstrate that LIFTED significantly enhances performance in predicting clinical trial outcomes across all three phases compared to the best baseline, showcasing the effectiveness of our proposed key components.