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Predicting response to cancer immunotherapy using noninvasive radiomic biomarkers

Open access
Trebeschi, S., Drago, S.G., Birkbak, N.J., Kurilova, I., Cǎlin, A.M., Delli Pizzi, A., Lalezari, F., Lambregts, D.M.J., Rohaan, M.W., Parmar, C., Rozeman, E.A., Hartemink, K.J., Swanton, C., Haanen, J B A G, Blank, C.U., Smit, E.F., Beets-Tan, R.G.H., Aerts, H.J.W.L·2019·Annals of Oncology

Abstract

INTRODUCTION: Immunotherapy is regarded as one of the major breakthroughs in cancer treatment. Despite its success, only a subset of patients responds-urging the quest for predictive biomarkers. We hypothesize that artificial intelligence (AI) algorithms can automatically quantify radiographic characteristics that are related to and may therefore act as noninvasive radiomic biomarkers for immunotherapy response. PATIENTS AND METHODS: In this study, we analyzed 1055 primary and metastatic lesions from 203 patients with advanced melanoma and non-small-cell lung cancer (NSCLC) undergoing anti-PD1 therapy. We carried out an AI-based characterization of each lesion on the pretreatment contrast-enhanced CT imaging data to develop and validate a noninvasive machine learning biomarker capable of distinguishing between immunotherapy responding and nonresponding. To define the biological basis of the radiographic biomarker, we carried out gene set enrichment analysis in an independent dataset of 262 NSCLC patients. RESULTS: The biomarker reached significant performance on NSCLC lesions (up to 0.83 AUC, P < 0.001) and borderline significant for melanoma lymph nodes (0.64 AUC, P = 0.05). Combining these lesion-wide predictions on a patient level, immunotherapy response could be predicted with an AUC of up to 0.76 for both cancer types (P < 0.001), resulting in a 1-year survival difference of 24% (P = 0.02). We found highly significant associations with pathways involved in mitosis, indicating a relationship between increased proliferative potential and preferential response to immunotherapy. CONCLUSIONS: These results indicate that radiographic characteristics of lesions on standard-of-care imaging may function as noninvasive biomarkers for response to immunotherapy, and may show utility for improved patient stratification in both neoadjuvant and palliative settings.

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Metadata

Authors
Trebeschi, S., Drago, S. G., Birkbak, N. J., Kurilova, I., Cǎlin, A. M., Delli Pizzi, A., Lalezari, F., Lambregts, D. M. J., Rohaan, M. W., Parmar, C., Rozeman, E. A., Hartemink, K. J., Swanton, C., Haanen, J. B. A. G., Blank, C. U., Smit, E. F., Beets-Tan, R. G. H., & Aerts, H. J. W. L.
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2019-06
Volume
30
Issue
6
Pages
998-1004
ISSN
0923-7534 (ISSN-L)
OpenAlex
W2923501617
Cited by
566
References
41
FWCI
40.05
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Predicting response to cancer immunotherapy using noninvasive radiomic biomarkers. https://app.cochat.ai/papers/10.1093/annonc/mdz108
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Trebeschi, S., Drago, S. G., Birkbak, N. J., Kurilova, I., Cǎlin, A. M., Delli Pizzi, A., Lalezari, F., Lambregts, D. M. J., Rohaan, M. W., Parmar, C., Rozeman, E. A., Hartemink, K. J., Swanton, C., Haanen, J. B. A. G., Blank, C. U., Smit, E. F., Beets-Tan, R. G. H., & Aerts, H. J. W. L. (2019). Predicting response to cancer immunotherapy using noninvasive radiomic biomarkers. Annals of Oncology. https://doi.org/10.1093/annonc/mdz108

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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