Owkin, the Francis Crick Institute and The Royal Marsden NHS Foundation Trust to use AI to research kidney cancer evolution

Owkin, the Francis Crick Institute and The Royal Marsden NHS Foundation Trust to use AI to research kidney cancer evolution

– The Francis Crick Institute and The Royal Marsden team up with AI startup Owkin to understand the relationship between evolutionary and histological features in kidney cancer –

– Cases of renal cell carcinoma (RCC) have more than doubled in the UK since the late 1970s –

Owkin is partnering with scientists from the Francis Crick Institute and The Royal Marsden NHS Foundation Trust in London to use artificial intelligence (AI) to research how the evolution of a kidney cancer tumour is linked to differences in its microscopic structure, with the ultimate goal of helping doctors to improve the way the disease is treated.

Kidney cancer rates are increasing, largely due to an ageing population, increasing obesity and smoking. Research suggests that a possible reason for treatment failure is intratumor heterogeneity – distinct tumour cell populations within a tumour with differing molecular and phenotypical profiles. Treating the disease requires an understanding of the characteristics of an individual’s tumour, which can vary widely between patients. If doctors can predict a patient’s outcomes based on these characteristics, then they can tailor treatments to suit their individual needs – known as precision medicine.

To help to build the scientific basis for this, researchers from Owkin, the Crick Institute and The Royal Marsden NHS Foundation Trust are using AI to better understand how the evolution of renal cell carcinoma (RCC), the most common kidney cancer, relates to tumour histology. By using AI to analyse over 1000 tissue samples from 100 different tumours, researchers hope to find a way to predict unique evolutionary features in every patient. These features in turn can predict patient outcomes. 

Tumour evolution can be grouped into three categories (or “modes” of evolution) that are associated with clinical outcomes. They are characterised by differing levels of chromosomal complexity (or weighted genomic instability, a measure of how unstable the genome is) and intratumoral heterogeneity.

Some kidney cancers grow very slowly, while others grow rapidly and spread around the body, making it challenging to predict outcomes for individual patients. However, evolutionary features – meaning how the tumour has evolved through a series of genetic changes over time – associate closely with specific outcomes. By deploying machine learning to better understand how these outcomes relate to histological characteristics of the tumour, the project aims to improve our fundamental understanding of disease mechanics and help the transition to precision medicine. 

Dr Samra Turajlic, Group Leader at the Francis Crick Institute and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said: 

“We know that the outcomes of any individual patient with kidney cancer are determined by the distinct way their tumour evolves. We want to be able to predict the next step in a tumour’s evolutionary trajectory and better tailor treatments that can effectively tackle a patient’s cancer.

“New technologies and tools are critical in helping us achieve this at a scale and speed that is required in clinical practice, and at a cost that will make these measurements implementable in most healthcare systems.”

Thomas Clozel MD, Co-founder and CEO of Owkin, said:

“Owkin’s mission is to find the right treatment for every patient. By using AI to improve our fundamental understanding of kidney cancer tumours, we aim to enable doctors to move towards a precision medicine approach to treatment. We are excited to be working with the Crick Institute and the Royal Marsden Hospital to make a lasting difference to the lives of patients.”

By using rapid and low-cost AI on digital pathology slides rather than large-scale genomic sequencing, which can be cost-prohibitive, the project hopes to help the day-to-day management of patients in a cost-effective, implementable way.

For clinical settings, the project opens new possibilities for the interpretation of routine kidney cancer biopsies. For research settings, the project aims to discover valuable insights into the interindividual differences in tumour evolution, progression and treatment resistance, building our scientific understanding of how to best treat kidney cancer.

A high magnification micrograph of a clear cell renal cell carcinoma (RCC).

Cases of renal cell carcinoma (RCC) have more than doubled in the UK since the late 1970s to around 10,000 new diagnoses every year. 50% of patients present with advanced disease and have a five-year survival rate of just 5%. Since the early 1970s, the mortality rate for kidney cancer in the UK has increased by almost three-quarters (73%).

The project supports the work of TRACERx (TRAcking Cancer Evolution through therapy (Rx)), a major translational research study aimed at transforming our understanding of cancer evolution and moving towards an era of precision medicine. TRACErX Renal has received funding from Cancer Research UK, the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research, London, and The Royal Marsden Cancer Charity.