arXiv:2509.20975cs.LGcs.AI2025-09ICLR

用大模型当黑箱优化器,靠医学知识推荐个性化治疗方案。

Knowledgeable Language Models as Black-Box Optimizers for Personalized Medicine

  • 用大模型结合医学知识图谱生成治疗方案
  • 在真实任务中优于传统和现有LLM方法
  • 无需微调,适合医疗个性化研究者

个性化医疗的目标是根据患者的基因和环境因素,找到最优治疗方案。但由于不能随意给患者试药,通常依赖计算机模拟的代理模型来估算治疗效果。然而,这些代理模型难以泛化到未见的患者-治疗组合。本文提出基于大语言模型的熵引导优化方法(LEON),利用医学教科书和生物医学知识图谱等先验知识,作为治疗方案优劣的替代信号。通过“提示优化”机制,让大模型在不进行任务微调的情况下,以自然语言形式生成个性化治疗设计。实验表明,在真实优化任务中,LEON在推荐个体化治疗方案方面优于传统方法和现有基于LLM的方法。

原文摘要 · Abstract (English)

The goal of personalized medicine is to discover a treatment regimen that optimizes a patient's clinical outcome based on their personal genetic and environmental factors. However, candidate treatments cannot be arbitrarily administered to the patient to assess their efficacy; we often instead have access to an in silico surrogate model that approximates the true fitness of a proposed treatment. Unfortunately, such surrogate models have been shown to fail to generalize to previously unseen patient-treatment combinations. We hypothesize that domain-specific prior knowledge - such as medical textbooks and biomedical knowledge graphs - can provide a meaningful alternative signal of the fitness of proposed treatments. To this end, we introduce LLM-based Entropy-guided Optimization with kNowledgeable priors (LEON), a mathematically principled approach to leverage large language models (LLMs) as black-box optimizers without any task-specific fine-tuning, taking advantage of their ability to contextualize unstructured domain knowledge to propose personalized treatment plans in natural language. In practice, we implement LEON via 'optimization by prompting,' which uses LLMs as stochastic engines for proposing treatment designs. Experiments on real-world optimization tasks show LEON outperforms both traditional and LLM-based methods in proposing individualized treatments for patients.

个性化医疗大模型优化知识图谱治疗推荐

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