Clinical usability of an explainable AI decision support tool and evaluation of multimodal models in NSCLC - Report - MDSpire
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Evaluation of an Explainable AI Decision Support Tool and the Effectiveness of Multimodal Models in Non-Small Cell Lung Cancer Management

  • By

  • Arsela Prelaj

  • Vanja Miskovic

  • Matteo Sacco

  • Alberto Ferrarin

  • Cristina Maria Licciardello

  • Leonardo Provenzano

  • Margherita Favali

  • Ludovica Lerma

  • Aleksandra Zec

  • Andrea Spagnoletti

  • Monica Ganzinelli

  • Daniele Lorenzini

  • Beshoy Guirges

  • Luca Invernizzi

  • Cecilia Silvestri

  • Laura Mazzeo

  • Marco Meazza Prina

  • Giulia Corrao

  • Margherita Ruggirello

  • Andra Diana Dumitrascu

  • Rosa Maria Di Mauro

  • Dario Monzani

  • Gabriella Pravettoni

  • Michele Zanitti

  • Davide Macocchi

  • Moreno Bruno Marino

  • Chiara Cavalli

  • Rebecca Romanò

  • Claudia Giani

  • Samuel G. Armato

  • Alessandra Esposito

  • Christine M. Bestvina

  • Maria Spector

  • Bogot R. Naama

  • Reham Basheer

  • Adi Lahiani Hafzadi

  • Laila Roisman

  • Iris Watermann

  • Marlen Szewczyk

  • Till Olchers

  • Heinz Richter

  • Constantin Blanke-Roeser

  • Costanza Siniscalchi

  • Anna Di Lello

  • Teresa Arangoa

  • Valentina Bartolomeo

  • Nikolaos Spathas

  • Evangelos Sarris

  • Elena Fountzilas

  • Aina Arbusà Roca

  • Rocio Caro-Consuegra

  • Patricia Iranzo

  • Melissa Fernández-Pinto

  • Jose Rodríguez-Morató

  • Luca Agnelli

  • Mario Occhipinti

  • Marta Brambilla

  • Teresa Beninato

  • Claudia Proto

  • Sokol Kosta

  • Michele Pio Di Palma

  • Eliana Rulli

  • Stefan Steurer

  • Ronald Simon

  • Michael Willis

  • Giancarlo Pruneri

  • Filippo De Braud

  • Marcello Restelli

  • Enriqueta Felip

  • Nir Peled

  • Alexander T. Pearson

  • Helena Linardou

  • Martin Reck

  • Giuseppe Lo Russo

  • Francesco Trovò

  • Alessandra Laura Giulia Pedrocchi

  • Marina Chiara Garassino

  • September 13, 2026

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Clinical Report: Evaluation of an Explainable AI Decision Support Tool

Overview

This study evaluates an AI-based decision support system for optimizing immunotherapy selection in advanced non-small cell lung cancer (NSCLC).

Background

Lung cancer remains the leading cause of cancer mortality globally. The limited long-term benefits of current immunotherapy approaches highlight the need for robust predictive biomarkers to identify patients likely to respond to treatment.

Data Highlights

Data TypeSample Size
Clinical Biomarkers2,396
Genomic Testing1,723
CT Imaging1,705
Histopathology Slides936

Key Findings

  • The study involved 2,396 patients with advanced NSCLC across six clinical centers.
  • AI-based decision support systems were developed using multimodal data, including clinical biomarkers, genomic testing, and imaging.
  • Primary resistance to immunotherapy occurs in 5–20% of patients, with secondary resistance in 60–85%.
  • PD-L1 remains the only clinically approved biomarker.
  • Multimodal models have shown improved performance over traditional biomarkers in predicting immunotherapy responses.

Clinical Implications

Clinicians should consider the potential of multimodal data in treatment selection for patients with advanced NSCLC.

Conclusion

The findings indicate that AI-driven approaches can improve the decision-making process in immunotherapy for NSCLC.

Related Resources & Content

  1. ASCO AI in Oncology, 2026 -- AI-Driven Multiagent System for Guiding First-Line Immunotherapy for NSCLC
  2. Frontiers in Oncology, 2026 -- Clinical evaluation of large language model recommendations in melanoma: comparison with multidisciplinary tumor board decisions in a real-world cohort
  3. DIGITAL HEALTH, 2026 -- Assessment of Large Language Models in Clinical Scenarios for Lung Cancer: A Comparative Analysis
  4. ASCO AI in Oncology, 2026 -- Multimodal AI Informs Adjuvant Chemotherapy Decisions in Node-Positive Breast Cancer
  5. Journal of Clinical Oncology, 2026 -- Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, 2026.3.0
  6. Journal of Clinical Oncology, 2021 -- Five-Year Outcomes With Pembrolizumab Versus Chemotherapy for Metastatic Non–Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50%
  7. Journal of Clinical Oncology, 2026 -- Therapy for Stage IV Non–Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.2
  8. Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, 2026.3.0 | Journal of Clinical Oncology
  9. Five-Year Outcomes With Pembrolizumab Versus Chemotherapy for Metastatic Non–Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50% | Journal of Clinical Oncology
  10. Therapy for Stage IV Non–Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.2 | Journal of Clinical Oncology

Original Source(s)

Clinical usability of an explainable AI decision support tool and evaluation of multimodal models in NSCLC

  • by Arsela Prelaj, Vanja Miskovic, Matteo Sacco, Alberto Ferrarin, Cristina Maria Licciardello, Leonardo Provenzano, Margherita Favali, Ludovica Lerma, Aleksandra Zec, Andrea Spagnoletti, Monica Ganzinelli, Daniele Lorenzini, Beshoy Guirges, Luca Invernizzi, Cecilia Silvestri, Laura Mazzeo, Marco Meazza Prina, Giulia Corrao, Margherita Ruggirello, Andra Diana Dumitrascu, Rosa Maria Di Mauro, Dario Monzani, Gabriella Pravettoni, Michele Zanitti, Davide Macocchi, Moreno Bruno Marino, Chiara Cavalli, Rebecca Romanò, Claudia Giani, Samuel G. Armato, Alessandra Esposito, Christine M. Bestvina, Maria Spector, Bogot R. Naama, Reham Basheer, Adi Lahiani Hafzadi, Laila Roisman, Iris Watermann, Marlen Szewczyk, Till Olchers, Heinz Richter, Constantin Blanke-Roeser, Costanza Siniscalchi, Anna Di Lello, Teresa Arangoa, Valentina Bartolomeo, Nikolaos Spathas, Evangelos Sarris, Elena Fountzilas, Aina Arbusà Roca, Rocio Caro-Consuegra, Patricia Iranzo, Melissa Fernández-Pinto, Jose Rodríguez-Morató, Luca Agnelli, Mario Occhipinti, Marta Brambilla, Teresa Beninato, Claudia Proto, Sokol Kosta, Michele Pio Di Palma, Eliana Rulli, Stefan Steurer, Ronald Simon, Michael Willis, Giancarlo Pruneri, Filippo De Braud, Marcello Restelli, Enriqueta Felip, Nir Peled, Alexander T. Pearson, Helena Linardou, Martin Reck, Giuseppe Lo Russo, Francesco Trovò, Alessandra Laura Giulia Pedrocchi, Marina Chiara Garassino

  • September 13, 2026

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