Scientific Publications

From our Scientific Team in Clinical AI, vaccine development, immunology and infectious disease.

ABSTRACT

Evaluation of Bowhead health patient navigator for breast cancer treatment in India: A pilot study.

View on ASCO

Abstract e13659

Background: Access to guideline-concordant cancer treatment is a significant challenge in India due to limited resources and variability in clinical care practices. The Bowhead Health Patient Navigator (BHPN) is a digital tool designed to deliver evidence-based, personalized treatment recommendations for breast and lung cancer. This pilot study evaluated the accuracy and applicability of BHPN recommendations compared to official treatment guidelines, local tumor board decisions, and real-world practices for breast cancer.

Methods: Matching of 40 synthetic breast cancer cases to India's cancer care guidelines was conducted using BHPN. Synthetic data was developed by two surgical medical oncologists from India. BHPN's processing pipeline operates entirely on-premise within secure cloud infrastructure, ensuring data localization and compliance. The primary objective was to compare BHPN recommendations to standard treatment guidelines, with a target accuracy of 95%.

Results: BHPN achieved 92% concordance with guideline-based recommendations and 89% with tumor board decisions. The platform generated personalized treatment plans, such as hormone therapy for premenopausal ER-positive breast cancer patients, while accounting for comorbidities. The localized data processing approach ensured end-to-end privacy while enabling real-time clinical trial matching.

Conclusions: BHPN demonstrates significant potential in transforming cancer care delivery by providing secure, guideline-concordant, and personalized recommendations. Its on-premise design and compliance-focused architecture ensure adaptability and scalability in resource-constrained settings. Further validation with larger datasets and real-world implementations is recommended to confirm its impact on oncology outcomes in underserved regions.

2

Early Readout on Overall Survival of Patients With Melanoma Treated With Immunotherapy Using a Novel Imaging Analysis

Authors: Dercle, L., Zhao, B., Gönen, M., Moskowitz, C. S., Firas, A., Beylergil, V., … Schwartz, L. H.
Date: 2022 (Published Online Jan 20 2022)
Source: JAMA Oncology 8(3): 385-392. JAMA Network

In 575 advanced-melanoma patients treated with immunotherapy, a radiomics signature (4 imaging features) achieved AUC ~0.92 for estimating 6-month survival vs ~0.80 for RECIST 1.1. JAMA Network

5

Artificial intelligence: A transformative tool in precision oncology

Authors: McGale, J., Liao, M.J., Lopci, E., Marabelle, A., Dercle, L.
Date: 2024 (Aug 26)
Source: Oncotarget 15: 588-589. Oncotarget

Editorial piece discussing the role of AI in precision oncology, special focus on immunotherapy, imaging biomarkers, and the imperative of clinical translation. PubMed+1

6

Immunogenicity and Safety of a 3-Antigen Hepatitis B Vaccine vs a Single-Antigen Hepatitis B Vaccine: A Phase 3 Randomized Clinical Trial

Authors: Vesikari, T., Finn, A., Manns, M. P., Spaans, K. F., Yassin-Rajkumar, A., Anderson, E. J., & Diaz-Mitoma, F.
Date: October 12, 2021
Source: JAMA Network Open

This pivotal Phase 3 randomized clinical trial evaluated a novel 3-antigen HBV vaccine against the standard single-antigen vaccine in 2,838 healthy adults. The study demonstrated the superiority of the 3-antigen vaccine, which achieved significantly higher seroprotection rates after both two doses (90.4% vs. 51.6%) and three doses (99.3% vs. 94.8%). The 3-antigen vaccine also induced a faster and more robust antibody response, establishing its potential to provide quicker and more comprehensive protection against HBV infection.

7

Comparison of safety and immunogenicity of two doses of investigational hepatitis B virus surface antigen co-administered with an immunostimulatory phosphorothioate oligodeoxyribonucleotide and three doses of a licensed hepatitis B vaccine in healthy adults 18-55 years of age

Authors: Halperin, S. A., Ward, B., Cooper, C., Predy, G., Diaz-Mitoma, F., et al.
Date: March 23, 2012
Source: Vaccine

In this large-scale study of 2,415 adults, a two-dose regimen of an HBV vaccine with a novel immunostimulatory adjuvant (HBV-ISS) was compared to the standard three-dose regimen of Engerix-B. The two-dose HBV-ISS vaccine was found to be statistically superior, achieving a seroprotection rate of 95.1% compared to 81.1% for the standard vaccine. The study concluded that the shorter, two-dose schedule induced a more rapid and superior antibody response, directly addressing the clinical challenge of patient compliance with the traditional six-month vaccination schedule.

8

Patient-initiated, twice-daily oral famciclovir for early recurrent genital herpes. A randomized, double-blind multicenter trial

Authors: Sacks, S. L., Aoki, F. Y., Diaz-Mitoma, F., Sellors, J., & Shafran, S. D.
Date: July 3, 1996
Source: JAMA (Journal of the American Medical Association)

This landmark trial pioneered a "patient-initiated" study design where participants self-diagnosed a recurrence of genital herpes and began treatment immediately. The study showed that oral famciclovir was significantly more effective than placebo at reducing the time to lesion healing, cessation of viral shedding, and duration of uncomfortable symptoms. This work established episodic, patient-initiated therapy as a convenient and effective alternative to continuous suppression for managing recurrent genital herpes.

9

Improvement in Cell-Mediated Immune Function during Potent Anti-Human Immunodeficiency Virus Therapy with Ritonavir plus Saquinavir

Authors: Angel, J. B., Kumar, A., Parato, K., Filion, L. G., Diaz-Mitoma, F., Daftarian, P., et al.
Date: April 1, 1998
Source: The Journal of Infectious Diseases

This study investigated whether potent antiviral therapy could restore functional immunity in HIV-infected patients. In 41 patients treated with ritonavir and saquinavir, the therapy not only suppressed viral load and increased CD4+ T-cell counts but also led to significant improvements in functional measures, including T-cell proliferative responses and the production of key cytokines (IL-2, IL-12, IL-10). The research provided crucial evidence that potent viral suppression can lead to true immune reconstitution, demonstrating that HIV-induced immune damage is a potentially reversible process.

10

IL-10 production is enhanced in human T cells by IL-12 and IL-6 and in monocytes by tumor necrosis factor-α

Authors: Daftarian, P. M., Kumar, A., Kryworuchko, M., & Diaz-Mitoma, F.
Date: July 1, 1996
Source: The Journal of Immunology

This foundational research provided a key insight into the regulation of the anti-inflammatory cytokine Interleukin-10 (IL-10). The study discovered that IL-10 production is differentially regulated in T-cells (enhanced by IL-12 and IL-6) and monocytes (enhanced by TNF-α). This finding described a classic negative feedback loop where pro-inflammatory signals induce their own inhibitor, a fundamental mechanism for maintaining immune system balance that is highly relevant to the rational design of vaccine adjuvants.

11

Enhancing Oral Vaccine Potency by Targeting Intestinal M Cells

Authors: Azizi, A., Kumar, A., Diaz-Mitoma, F., & Mestecky, J.
Date: November 11, 2010
Source: PLoS Pathogens

This review article addresses a key goal in vaccinology: effective oral vaccine delivery. The authors propose a strategic path forward by actively targeting vaccine antigens to microfold (M) cells, the primary antigen-sampling gateways in the gut. By designing delivery systems that bind to M-cell receptors, the efficiency of antigen uptake could be dramatically enhanced, potentially leading to potent mucosal and systemic immune responses from an oral dose.

12

Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial

Authors: Cunningham, A. L., Heineman, T. C., Lal, H., Godeaux, O., et al.
Date: October 2019 (Published online August 20, 2019)
Source: The Lancet Infectious Diseases

This Phase 3 trial evaluated an inactivated vaccine to prevent shingles (herpes zoster) in high-risk cancer patients. The vaccine was found to be well-tolerated and effective in patients with solid tumors undergoing chemotherapy, demonstrating a 63.6% efficacy. However, it was not efficacious in patients with hematological malignancies, a finding that underscores the distinct immunological challenges present in different immunocompromised populations.

13

Natural history of progression of HPV infection to cervical lesion or clearance: analysis of the control arm of the large, randomised PATRICIA study

Authors: Skinner, S. R., Szarewski, A., Romanowski, B., et al. (on behalf of the PATRICIA Study Group)
Date: November 19, 2013
Source: PLoS One

This analysis leveraged data from the control arm of the major PATRICIA HPV vaccine trial to precisely map the natural history of HPV infections. The study provided critical estimates for the risk of progression from persistent infection to high-grade cervical lesions, identifying HPV-16 and HPV-33 as carrying a ~25-fold higher risk for progression to CIN3+. This work provides essential data for public health modeling and vaccination strategies.

14

Innovative bioinformatic approaches for developing peptide-based vaccines against hypervariable viruses

Authors: Sirskyj, D., Diaz-Mitoma, F., Golshani, A., Kumar, A., & Azizi, A.
Date: January 2011
Source: Immunology and Cell Biology

This review article explores the use of modern computational and bioinformatic tools for the rational design of peptide-based vaccines. It focuses on strategies to overcome the challenges posed by hypervariable viruses (e.g., HIV, influenza) that rapidly mutate and escape traditional immune responses. The paper highlights a forward-looking approach to vaccine development that relies on predictive algorithms and computational biology to identify stable and effective vaccine targets.

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