Pretreatment radiomic biomarker for immunotherapy responder prediction in IB-IV stage NSCLC: A multi-center retrospective study.

Authors

null

Shaowei Wu

Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Shaowei Wu , HaiYu Zhou , Daipeng Xie , Lintong Yao

Organizations

Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China, Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, /, China, Guangdong Provincial People's Hospital, Guangzhou, China, Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

Research Funding

Other
National Natural Science Foundation of China (52203163)

Background: The current biomarker of immune checkpoint inhibitors (ICIs) efficacy is not sufficient. This study investigated the correlation between radiomic biomarker and immunotherapy responder in patients with IB-IV stage non-small-cell lung cancer (NSCLC), including its biological explanation for ICIs treatment response prediction. Methods: CT images from 319 pretreatment NSCLC patients receiving immunotherapy between January, 2015 and November, 2021 were retrospectively collected and were distributed into a discovery (n = 214), independent validation (n = 54), and external test cohort (n = 51). 851 features were extracted from both tumoral and each peri-tumoral VOIs. The reference standard is the durable clinical benefit (DCB) and the crucial exclusion criteria are missing pretreatment CT scans. The predictive value of combined radiomic signature (CRS) was assessed in a cohort of 98 resectable NSCLC patients receiving ICIs. The association of radiomic features and tumor immune landscape on the online dataset (n = 60) was also evaluated. A clinical model was constructed and incorporated with radiomic signature to improve performance further. Results: CRS discriminated between DCB and non-DCB patients in the training cohort (area under the curve (AUC): 0.82, 95% CI: 0.75 to 0.88)) and independent cohort (AUC: 0.75, 95%CI: 0.62 to 0.88). In this study, the predictive value of CRS was better than PD-L1 expression (AUC of PD-L1 subset: 0.59, 95%CI: 0.50 to 0.69) or clinical model (AUC of validation cohort: 0.66, 95%CI: 0.51 to 0.81). When predicting pathological response, CRS divided patients into a major pathological response (MPR) and non-MPR group (AUC: 0.76, 95%CI: 0.67 to 0.81). Moreover, CRS showed a promising stratified ability on overall survival (OS; HR: 0.48, 95%CI: 0.27 to 0.89; p = 0.020) and progression-free survival (PFS; HR: 0.43, 95%CI: 0.26 to 0.74; p = 0.002). Biological pathway analysis on online dataset revealed that dysregulation of Hedgehog and Hippo signaling pathways got involved in the prediction of radiomic features. Conclusions: By analyzing both tumoral and peri-tumoral regions of CT images in a radiomic strategy, we developed a non-invasive biomarker distinguishing responder from ICIs therapy, which might inform clinical decisions on the use of ICIs in advanced as well as resectable NSCLC patients.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e21060)

DOI

10.1200/JCO.2023.41.16_suppl.e21060

Abstract #

e21060

Abstract Disclosures

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