Cancer genomic analysis requires accurate identification of somatic variants in sequencing data. Manual review to refine somatic variant calls is required as a final step after automated processing. However, manual variant refinement is time-consuming, costly, poorly standardized, and non-reproducible. Here, we systematized and standardized somatic variant refinement using a machine learning approach. The final model incorporates 41,000 variants from 440 sequencing cases. This model accurately recapitulated manual refinement labels for three independent testing sets (13,579 variants) and accurately predicted somatic variants confirmed by orthogonal validation sequencing data (212,158 variants). The model improves on manual somatic refinement by reducing bias on calls otherwise subject to high inter-reviewer variability.

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Data availability

All analysis, preprocessing code, readcount training data, manual review calls, and trained deep learning and random forest models are available on the DeepSVR GitHub repository (https://github.com/griffithlab/DeepSVR). The raw sequencing data are publicly available for most projects included in this study (Supplementary Table 8). Users can access the classifier command line interface via our open-sourced GitHub repository and can install the package through Bioconda49. After installation, the tool can be used to (1) train and save a deep learning classifier, (2) prepare data for training a classifier or classification, and (3) classify data using either the provided deep learning model or a custom model. A walkthrough of this process is available on the DeepSVR GitHub Wiki.

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The authors thank A. Petti, G. Chang, T. Li, C. Miller, L. Trani, R. Lesurf, Z. Skidmore, K. Krysiak, A. Ramu, and F. Gomez for assisting in data assembly. We also acknowledge L. Trani for performing manual review and for valuable discussion on the project. We gratefully acknowledge L. Wartman, J. DiPersio, M. Jacoby, B. Van Tine, R. Fields, B. Tan, S. Chi, D. Gutmann, and T. Ley for sharing genomic data that made this project possible. The authors also thank the patients and their families for their selfless contribution to the advancement of science. Part of this work was performed as part of the Washington University School of Medicine Genomics Tumor Board, which was funded with private research support from the Division of Oncology and the McDonnell Genome Institute. E.K.B. was supported by the National Cancer Institute (T32GM007200 and U01CA209936). T.E.R. received support from the National Institutes of Health/National Cancer Institute (NIH/NCI) (R01CA142942) and the Breast Cancer Research Foundation. Select sample data was funded by the Genomics of AML PPG (T. Ley, PI, P01 CA101937). A.H.W. was supported by the NCI (NIH NCI F32CA206247). B.J.A. was supported by the Siteman Cancer Center. S. Swamidass is funded by the National Library of Medicine (NIH NLM R01LM012222 and NIH NLM R01LM012482) and acknowledges support from the Institute for Informatics at Washington University School of Medicine. M.G. is funded by the National Human Genome Research Institute (NIH NHGRI R00HG007940). O.L.G. is funded by the National Cancer Institute (NIH NCI K22CA188163 and NIH NCI U01CA209936).

Author information

Author notes

  1. These authors contributed equally: Benjamin J. Ainscough, Erica K. Barnell.


  1. McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO, USA

    • Benjamin J. Ainscough
    • , Erica K. Barnell
    • , Peter Ronning
    • , Katie M. Campbell
    • , Alex H. Wagner
    • , Malachi Griffith
    •  & Obi L. Griffith
  2. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    • Benjamin J. Ainscough
    • , Todd A. Fehniger
    • , Ramaswamy Govindan
    • , Malachi Griffith
    •  & Obi L. Griffith
  3. Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    • Todd A. Fehniger
    • , Ramaswamy Govindan
    • , Malachi Griffith
    •  & Obi L. Griffith
  4. Department of Neurological Surgery, Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA

    • Gavin P. Dunn
  5. Department of Surgery/Otolaryngology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    • Ravindra Uppaluri
  6. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    • Thomas E. Rohan
  7. Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA

    • Malachi Griffith
    •  & Obi L. Griffith
  8. Institute for Genomic Medicine, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    • Elaine R. Mardis
  9. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    • Elaine R. Mardis
  10. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA

    • S. Joshua Swamidass
  11. Institute for Informatics, Washington University School of Medicine, St. Louis, MO, USA

    • S. Joshua Swamidass


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B.J.A. designed the study, assembled and cleaned training data, performed feature engineering, designed model architecture, tuned hyperparameters, performed model training and analysis, performed manual review, assembled validation data, wrote code, created figures, and wrote the manuscript. E.K.B. designed the study, performed manual review, performed model training and analysis, performed clinical data analysis, assembled validation data, wrote code, created figures, and wrote the manuscript. P.R. and K.M.C. wrote code, performed manual review, and edited the manuscript. A.H.W. wrote code. T.E.R., R.G., R.U., G.P.D, and T.A.F. shared genomic data that was used in training the model and revised the paper. M.G., E.R.M., S.J.S., and O.L.G. designed the study, supervised the project and revised the paper.

Competing interests

R.G. consults for Eli Lilly and Genentech. R.G. is on the board/honorarium for EMD Serono, Bristol-Myers Squibb, Genentech, Pfizer, Nektar, Merck, Celgene, Adaptimmune, GlaxoSmithKline, Phillips Gilmore. All remaining authors declare no competing interests.

Corresponding authors

Correspondence to S. Joshua Swamidass or Obi L. Griffith.

Integrated supplementary information

  1. Supplementary Figure 1 The deep learning model performs well on the hold out test set (n = 13,530 variants), tenfold cross-validation with a simplified disease feature (n = 27,470 variants), and tenfold cross-validation with the reviewer feature removed (n = 27,470 variants).

    a, ROC curve and reliability diagram performance of the deep learning model on the hold out test set with all 71 described features. b, ROC curve and reliability diagram performance of the deep learning model tenfold cross-validation set with the cancer type simplified to solid versus liquid tumor status. c, ROC curve and reliability diagram performance of the deep learning model tenfold cross-validation set with the reviewer feature removed.

  2. Supplementary Figure 2 Deep learning model outputs from the hold out test set (n = 13,530 variants) are well scaled across all predicted classes (ambiguous, fail, and somatic).

    The correlation between the model output and the manual review call was assessed for all three different classes of calls (ambiguous, fail, and somatic). For each class, model outputs were binned into ten groups ranging from 0.00–1.00. For each bin, the total number of manual review calls that agree and disagree with the individual class were plotted. The ratio of agreement to disagreement was plotted for each bin and compared to the identity line (x = y) using the Pearson’s correlation coefficient (r).

  3. Supplementary Figure 3 The deep learning model performs better than the random forest model on independent sequencing data with manual review labels (n = 4 small-cell lung cancer cases with 2,686 total variants).

    a, ROC curves outlining deep learning and random forest model performances on independent sequencing data with manual review labels (n = 4 small-cell lung cancer cases with 2,686 total variants). b, Curves showing batch effect correction after re-training machine learning models with incremental subsets of variants from the independent sequencing data. Independent sequencing data were partitioned in random stratified increments of 5% (from 0–75%) and used to train a new model (increments = 179 variants). The x axis outlines the number of independent variants included in training. The y axis plots the resulting model’s ROC AUC. The ambiguous class shows significant stochasticity due to low representation in the test dataset (n = 15 variants).

  4. Supplementary Figure 4 IGV snapshots of clinically relevant variants that were originally labeled as somatic by manual reviewers but were subsequently identified as fail using the deep learning model and manual re-review.

    a, Failure due to short inserts and directional artifacts. b, Failure due to multiple mismatches across variant-supporting reads. c, Failure due to multiple variant artifacts. d, Failure due to ends of reads artifact.

  5. Supplementary Figure 5 IGV snapshots of clinically relevant variants that were originally labeled as fail or ambiguous by manual reviewers but were subsequently identified as somatic using the deep learning model and manual re-review.

    For each snapshot, the normal tracks and the tumor tracks show aligned reads that were obtained from normal tissue and the tumor tissue, respectively. Variant summaries obtained from CIViC show gene name, variant type, variant coordinates, clinical summary, and relevant clinical action items. a, The original reviewer conservatively labeled both PIK3CA variants as ambiguous owing to multiple mismatches in reads; however, both variants appear to be somatic and occur at known cancer driver hotspots (E542K/E545K). b, The original reviewer failed this variant owing to high levels of variant reads in the normal track; however, given that this variant was derived from a hematologic malignancy, this level of tumor in normal is permissible.

  6. Supplementary Figure 6 Variants that show disagreement between the classifier and original manual review demonstrates high levels of inter-reviewer variability.

    Of the 10.7% of variants that disagree with the original manual review call, 179 variants were sampled to conduct manual re-review. When comparing the classifier call to the re-review consensus call, 41.9% of variants showed high inter-reviewer variability and/or inability to determine a consensus.

Supplementary information

  1. Supplementary Text and Figures

    Supplementary Figures 1–6

  2. Reporting Summary

  3. Supplementary Table 1

    List and description of the 71 features used to train the original machine learning models

  4. Supplementary Table 2

    Cross-tabulation performance on hold out test set parsed by reviewer, disease, normal sequencing depth, and tumor sequencing depth

  5. Supplementary Table 3

    Distribution of orthogonal validation calls from the AML31 case and the 106 The Cancer Genome Atlas (TCGA) tumor/normal pairs used to assess model performance

  6. Supplementary Table 4

    Distribution of manual review calls from the 37 cases used to assess model performance by independent sequencing data with manual review

  7. Supplementary Table 5

    Overlap between discrepant variants and CIViC annotations

  8. Supplementary Table 6

    Manual re-review of 179 variants by seven reviewers to develop a consensus call

  9. Supplementary Table 7

    Guide to development of a consensus label based on manual review calls from seven reviewers

  10. Supplementary Table 8

    List of the data availability of sequencing results for all cases used in the model development

  11. Supplementary Table 9

    Sequence Ontology IDs and description used to identify variants within the CIViC database that can be analyzed on DNA sequencing platforms

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