A CT-based Radiomics Signature Is Associated with Response to Immune Checkpoint Inhibitors in Advanced Solid Tumors.
影響因子： 7.931PMID：33497314期刊年卷：Radiology 2021 Jan 26;醫學一區 核醫學 Q1 4/129DOI：10.1148/radiol.2021200928作者列表: Ligero M, Garcia-Ruiz A, Viaplana C, …
Background
Reliable predictive imaging markers of response to immune checkpoint inhibitors are needed.
Purpose
To develop and validate a pretreatment CT-based radiomics signature to predict response to immune checkpoint inhibitors in advanced solid tumors.
Materials and Methods
In this retrospective study, a radiomics signature was developed in patients with advanced solid tumors (including breast, cervix, gastrointestinal) treated with anti-programmed cell death-1 or programmed cell death ligand-1 monotherapy from August 2012 to May 2018 (cohort 1). This was tested in patients with bladder and lung cancer (cohorts 2 and 3). Radiomics variables were extracted from all metastases delineated at pretreatment CT and selected by using an elastic-net model. A regression model combined radiomics and clinical variables with response as the end point. Biologic validation of the radiomics score with RNA profiling of cytotoxic cells (cohort 4) was assessed with Mann-Whitney analysis.
Results
The radiomics signature was developed in 85 patients (cohort 1: mean age, 58 years ± 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years ± 12; 37 men) and 47 patients (cohort 3: mean age, 64 years ± 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years ± 13; 14 men). The radiomics signature was associated with clinical response to immune checkpoint inhibitors (area under the curve [AUC], 0.70; 95% CI: 0.64, 0.77; < .001). In cohorts 2 and 3, the AUC was 0.67 (95% CI: 0.58, 0.76) and 0.67 (95% CI: 0.56, 0.77; < .001), respectively. A radiomics-clinical signature (including baseline albumin level and lymphocyte count) improved on radiomics-only performance (AUC, 0.74 [95% CI: 0.63, 0.84; < .001]; Akaike information criterion, 107.00 and 109.90, respectively).
Conclusion
A pretreatment CT-based radiomics signature is associated with response to immune checkpoint inhibitors, likely reflecting the tumor immunophenotype.
基於CT的放射組學特徵與晚期實體腫瘤對免疫檢查點抑制劑的反應有關
背景
對免疫檢查點抑制劑的反應需要可靠的預測成像標記物。
目的
開發和驗證一種基於CT的放射組學預處理徵象，以預測晚期實體瘤對免疫檢查點抑制劑的反應。
材料與方法
在這項回顧性研究中，對2012年8月至2018年5月期間接受抗程式性細胞死亡-1或程式性細胞死亡配體-1單一治療的晚期實體腫瘤(包括乳腺、宮頸、胃腸道)患者的放射組學特徵進行了研究(佇列1)。這在膀胱癌和肺癌患者(佇列2和3)中進行了測試。放射組學變數從所有在預處理CT上描繪的轉移灶中提取，並透過彈性網路模型進行選擇。以反應為終點，結合放射組學和臨床變數的迴歸模型。放射組學評分與細胞毒細胞RNA圖譜(佇列4)的生物學驗證採用Mann-Whitney分析進行評估。
結果
85例患者(佇列1：平均年齡58歲±13[標準差]；男性43例)獲得放射組學特徵，46例患者(佇列2：平均年齡70歲±12歲，男性37例)和47例患者(佇列3：平均年齡64歲±11歲，男性40例)進行了檢查。對另外20名患者進行了生物學驗證(佇列4：平均年齡60歲±13歲；14名男性)。放射組學特徵與對免疫檢查點抑制劑的臨床反應有關(曲線下面積[AUC]，0.70；95%CI：0.64，0.77；<0.001)。在佇列2和3中，AUC分別為0.67(95%CI：0.58，0.76)和0.67(95%CI：0.56，0.77；<0.001)。放射組學的臨床特徵(包括基線白蛋白水平和淋巴細胞計數)改善了僅有放射組學的表現(AUC0.74[95%CI：0.63，0.84；<0.001]；阿凱克資訊標準，分別為107.00和109.90)。
結論
預處理CT放射組學徵象與免疫檢查點抑制劑的反應有關，可能反映腫瘤的免疫表型。