AraC-Daunorubicin-Etoposide (ADE) Response Prediction in Pediatric AML Patients Using a Computational Biology Modeling (CBM) Based Precision Medicine Workflow

Background: Pediatric AML (pAML) treatment outcomes can vary due to genomic heterogeneity. Thus, selecting the right drugs for a given patient is challenging. There is a need for a priori means of predicting treatment responses based on tumor “omics”. Computational biology modeling (CBM) is a precision medicine approach by which biological pathways of tumorigenesis are mapped using mathematical principles to yield a virtual, interactive tumor model. This model can be customized based on a patient's omics and analyzed virtually for response to therapies. Aim: To define prediction values of a CBM precision medicine approach in matching clinical response to ADE therapy in a cohort of pAML patients. Methods: Thirty pAML patients that were treated ADE chemotherapy were utilized with information on the clinical, genomic (cytogenetics, mutations) and protein expression data from this cohort of pAML patients used for the CBM. From cytogenetics results, gene copy number variations were coded as either knocked-down (KD) or over-expressed (OE). From NGS results (2 gene panel - CEBPA, NPM1), gene mutations were coded as either loss or gain of function (LOF or GOF). For protein expression data, proteins that were >2sigma from the mean were coded as KD if their value was 0. Proteins with values