A CT-based radiomics signature is associated with response to immune checkpoint inhibitors in advanced solid tumors

Marta Ligero, Alonso Garcia-Ruiz, Cristina Viaplana, Guillermo Villacampa, Maria V. Raciti, Jaid Landa, Ignacio Matos, Juan Martin-Liberal, Maria Ochoa-De-Olza, Cinta Hierro, Joaquin Mateo, Macarena Gonzalez, Rafael Morales-Barrera, Cristina Suarez, Jordi Rodon, Elena Elez, Irene Braña, Eva Muñoz-Couselo, Ana Oaknin, Roberta FasaniPaolo Nuciforo, Debora Gil, Carlota Rubio-Perez, Joan Seoane, Enriqueta Felip, Manuel Escobar, Josep Tabernero, Joan Carles, Rodrigo Dienstmann, Elena Garralda, Raquel Perez-Lopez

Research output: Contribution to journalArticlepeer-review

Abstract

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 6 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years 6 12; 37 men) and 47 patients (cohort 3: mean age, 64 years 6 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years 6 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; P , .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; P , .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; P , .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.

Original languageEnglish
Pages (from-to)109-119
Number of pages11
JournalRadiology
Volume299
Issue number1
DOIs
Publication statusPublished - Apr 2021
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'A CT-based radiomics signature is associated with response to immune checkpoint inhibitors in advanced solid tumors'. Together they form a unique fingerprint.

Cite this