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Background: Ovarian cancer (OC) has the highest mortality among gynecological malignancies, and resistance to chemotherapy drugs is common. We aim to develop a machine learning approach based on gut microbiota to predict the chemotherapy resistance of OC. Methods: The study included patients diagnosed with OC by pathology and treated with platinum and paclitaxel in Shengjing Hospital of China Medical University between 2017 and 2018. Fecal samples were collected from patients, and 16S rRNA sequencing was used to analyze the differences in gut microbiota between OC patients with and without chemotherapy resistance. Nine machine learning classifiers were used to derive the chemotherapy resistance of OC from gut microbiota. Results: A total of 77 chemoresistant OC patients and 97 chemosensitive OC patients were enrolled. The gut microbiota diversity was higher in OC patients with chemotherapy resistance. There were statistically significant differences between the two groups in Shannon indexes (P &lt;0.05) and Simpson indexes (P &lt;0.05). Machine learning techniques can predict the chemoresistance of OC, and the random forest showed the best performance among all models. The area under the ROC curve for RF model was 0.909. Conclusions: The diversity of gut microbiota was higher in OC patients with chemotherapy resistance. Further studies are warranted to validate our findings based on machine learning techniques.

Application of machine learning in prediction of Chemotherapy resistant of Ovarian Cancer based on Gut Microbiota