Cited by 463Prostate Cancer Treatment and ResearchRadiomics and Machine Learning in Medical ImagingBreast Cancer Treatment Studies

Biologically informed deep neural network for prostate cancer discovery

Open access
Elmarakeby, Haitham A., Hwang, Justin, Arafeh, Rand, Crowdis, Jett, Gang, Sydney, Liu, David, AlDubayan, Saud H., Salari, Keyan +6 more·2021·Nature

Published version of a preprint

Abstract

Abstract The determination of molecular features that mediate clinically aggressive phenotypes in prostate cancer remains a major biological and clinical challenge 1,2 . Recent advances in interpretability of machine learning models as applied to biomedical problems may enable discovery and prediction in clinical cancer genomics 3–5 . Here we developed P-NET—a biologically informed deep learning model—to stratify patients with prostate cancer by treatment-resistance state and evaluate molecular drivers of treatment resistance for therapeutic targeting through complete model interpretability. We demonstrate that P-NET can predict cancer state using molecular data with a performance that is superior to other modelling approaches. Moreover, the biological interpretability within P-NET revealed established and novel molecularly altered candidates, such as MDM4 and FGFR1 , which were implicated in predicting advanced disease and validated in vitro. Broadly, biologically informed fully interpretable neural networks enable preclinical discovery and clinical prediction in prostate cancer and may have general applicability across cancer types.

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Crossref · 10.1038/s41586-021-03922-4

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  • P-NET applied hierarchical pathway information to construct a sparse deep neural network for inferring disease status-specific molecular alterations, aiding disease diagnosis and drug design for prostate cancer.

    “P-NET applied the hierarchical pathway information to construct a sparse deep neural network for inferring the disease status-specific molecular alterations, which aids in disease diagnosis and drug design for prostate cancer [116].”

    From Challenges in AI-driven Biomedical Multimodal Data Fusion and Analysis (2025) · cites this paper as [116]

    The Results and Methods (P-NET design) describe a sparse neural network built from hierarchical pathways to predict prostate cancer state from genomic profiles. The Discussion says it identified molecular candidates and potential therapeutic opportunities, but does not report drug design; it also frames clinical prediction as a potential application rather than an established diagnostic use. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Multiple deep learning methods have been developed to integrate biological pathway information with neural network architectures, but these methods are still limited by predefined pathway annotations.

    “While multiple deep learning methods have been developed to integrate biological pathway information with neural network architectures [116,166], these methods are still limited by the predefined pathway annotations.”

    From Challenges in AI-driven Biomedical Multimodal Data Fusion and Analysis (2025) · cites this paper as [116]

    The Main section describes several biologically informed neural networks, and the Discussion says P-NET depends on the quality of its hardcoded pathway annotations. The paper does not establish that all the methods mentioned share this limitation; that broader claim goes beyond its stated finding. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • The common approach for biological model design is to construct a neural network architecture restrained by biological pathways, connecting target gene nodes with pathway nodes, including P-NET, pmVAE, VEGA, and LDVAE.

    “The common approach for biological model design is to construct a neural network architecture that is restrained by biological pathways, specifically connecting target gene nodes with pathway nodes, including models of P-NET [116], pmVAE [163], VEGA [164], and LDVAE [165].”
  • P-NET is a sparse deep learning model that processes molecular profiling data in a pathway-driven fashion to predict prostate disease states such as metastases, and its prediction scores independently correlate with prognosis.

    “P-NET (112) is a sparse deep learning model that processes molecular profiling data in a biologically informed, pathway-driven fashion to predict prostate disease states such as metastases, where the resulting prediction scores were shown to independently correlate with prognosis.”

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2 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [16]Han S., Pool J., Tran J., Dally W. in Advances in Neural Information Processing Systems (eds Cortes C. et al.) 1135–1143 (Curran Associates, 2015).
  2. [22]Lundberg S. M., Lee S.-I. in Advances in Neural Information Processing Systems 30 (eds Guyon I. et al.) 4765–4774 (Curran Associates, 2017).

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Authors
Elmarakeby, H. A., Hwang, J., Arafeh, R., Crowdis, J., Gang, S., Liu, D., AlDubayan, S. H., Salari, K., Kregel, S., Richter, C., Arnoff, T. E., Park, J., Hahn, W. C., & Van Allen, E. M.
Affiliations
  • Broad Institute (US)
  • University of Minnesota (US)
  • Dana-Farber Cancer Institute (US)
  • University of Illinois Chicago (US)
Venue
Nature
Published
2021-09-22
Volume
598
Issue
7880
Pages
348-352
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W3199772305
Cited by
456
References
61
Citations by year
2026: 99 · 2025: 105 · 2024: 111 · 2023: 88 · 2022: 47 · 2021: 5 · 2020: 1
FWCI
41.88
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • U.S. Department of Defense (U01 CA233100, PC200150)
  • Movember Foundation
  • National Institutes of Health
  • National Cancer Institute (U01CA176058, U01CA233100)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords
prostate cancer, treatment resistance, interpretable neural networks, MDM4, FGFR1, cancer genomics, patient stratification, therapeutic targeting
MeSH terms
Deep Learning, Humans, Male, Prostatic Neoplasms, Proto-Oncogene Proteins, Receptors, Androgen, Reproducibility of Results, Tumor Suppressor Protein p53, Cell Cycle Proteins, Drug Resistance, Neoplasm, Receptor, Fibroblast Growth Factor, Type 1

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