Search arXivSearch

arXiv · 2409.00544

Large Language Models-Enabled Digital Twins for Precision Medicine in Rare Gynecological Tumors

Abstract

Rare gynecological tumors (RGTs) present major clinical challenges due to their low incidence and heterogeneity. The lack of clear guidelines leads to suboptimal management and poor prognosis. Molecular tumor boards accelerate access to effective therapies by tailoring treatment based on biomarkers, beyond cancer type. Unstructured data that requires manual curation hinders efficient use of biomarker profiling for therapy matching. This study explores the use of large language models (LLMs) to construct digital twins for precision medicine in RGTs. Our proof-of-concept digital twin system integrates clinical and biomarker data from institutional and published cases (n=21) and literature-derived data (n=655 publications with n=404,265 patients) to create tailored treatment plans for metastatic uterine carcinosarcoma, identifying options potentially missed by traditional, single-source analysis. LLM-enabled digital twins efficiently model individual patient trajectories. Shifting to a biology-based rather than organ-based tumor definition enables personalized care that could advance RGT management and thus enhance patient outcomes.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Jacqueline Lammert, Nicole Pfarr, Leonid Kuligin, Sonja Mathes, Tobias Dreyer, Luise Modersohn, Patrick Metzger, Dyke Ferber, Jakob Nikolas Kather, Daniel Truhn, Lisa Christine Adams, Keno Kyrill Bressem, Sebastian Lange, Kristina Schwamborn, Martin Boeker, Marion Kiechle, Ulrich A. Schatz, Holger Bronger, Maximilian Tschochohei. 2024-08-31. Large Language Models-Enabled Digital Twins for Precision Medicine in Rare Gynecological Tumors. https://doi.org/10.1038/s41746-025-01810-z

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

The Metanym Game: An LLM Benchmark Without Ground Truth That Rises With the Models It Measures

We introduce a benchmark that is fully self-contained, needs no ground truth, and rises with the models it measures. Language models compete at making analogies and subjectively grade one another; nothing enters from outside. The benchmark reproduces GPQA Diamond, a keyed benchmark of expert-written questions, at r = 0.98, audited for a leak and found clean. We hypothesize that both benchmarks measure the same thing in different ways: a language model holds its knowledge as archetypal contexts, relationship patterns valid across many topic domains. GPQA instantiates the required knowledge in one domain; the Metanym Game instantiates one archetype into several domains, generating analogies, no reasoning required. The reasoning feature of an LLM hardly changes the game's ratings, while it lifts GPQA, which requires derivations. In the game, a player writes a context template whose slots, filled with a set of keywords from a topic domain, instantiate a factually true description of that domain; the instantiations are each other's metaphors, and keywords filling the same slot are metanyms, metaphorically synonymous. Correctness is settled sentence by sentence. Ground truth is replaced by the SVD of the factual rating matrix: its left and right singular vectors rate the players as judges and as generators, two ratings from one factorisation, to our knowledge a first for an LLM council of peers. On the subjective criteria, judges are weighted by their rating consistency under a swept calibration anchor. Generating and judging are different skills: on this roster the strongest generators were middling judges. A council of the five best issues the official ratings; its contestable seats keep it current, a candidate steering signal for self-improving AI. The paper is accompanied by a validating package that recomputes every number.

cs.CL

SCoNE: Selective Context-aware Neuron Editing for Robust Retrieval-Augmented Generation

Retrieval-Augmented Generation (RAG) is highly sensitive to retrieval noise: when retrieved documents mix informative and irrelevant context, LLMs are easily distracted, leading to hallucinations. To overcome this, we propose SCoNE (Selective Context-aware Neuron Editing), a training-free model editing approach that improves retrieval noise robustness by selectively strengthening context-aware FFN neurons that are identified by both high attribution and high cross-input variability. SCoNE requires only a small number of mining samples, no fine-tuning, and no inference-time overhead. Across various knowledge-intensive question-answering benchmarks and two LLM backbones, SCoNE consistently outperforms competitive baseline methods. Our code is available at https://github.com/HYU-ARK-Lab/SCoNE.

cs.CL

COT-TTS: Audio Context-Aware Text-to-Speech with Chain-of-Thought Reasoning

Recently, text-to-speech systems have made significant progress in speech expressiveness and controllability. However, the speaking style of generated speech typically relies on clear user-specified instructions. In natural conversations, speaking style should be naturally inferred from the preceding conversational context. Therefore, we propose COT-TTS, a context-aware, reasoning-based text-to-speech task. Given historical conversation audio, target text, and a reference speech, the system should comprehend the conversational context, infer an explicit intermediate reasoning, and finally synthesize the target speech with the specified timbre. To support this task, we constructed a large-scale bilingual conversational speech dataset comprising 9 million training samples, including a high-quality subset of 1 million samples. We further constructed a source-disjoint benchmark with 800 human-verified samples and established strong task-specific baselines. Additionally, we developed end-to-end autoregressive models with parameter sizes of 0.6B and 1.7B, generating emotion-labeled transcripts, editable speech style inferences, and speech tokens. Experimental results show that the proposed model achieves performance comparable to large-scale baseline systems with significantly fewer parameters. At the same time, the model performs well in terms of duration consistency and emotional consistency, and can generate appropriate emotional, stress, and rhythmic variations based on the conversational context. To facilitate future research, we will publicly release the data construction pipeline, dataset, trained models, and related resources. The demo page and additional resources are available at https://luckybian.github.io/COT-TTS

cs.CL