Cited by 107Radiomics and Machine Learning in Medical ImagingCancer Immunotherapy and BiomarkersMedical Imaging Techniques and Applications

A CT-based Radiomics Signature is Associated with Response to Immune Checkpoint Inhibitors in Advanced Solid Tumors

Ligero, Marta, Garcia-Ruiz, Alonso, Viaplana, Cristina, Villacampa, Guillermo, Raciti, Maria V., Landa, Jaid, Matos, Ignacio, Martin-Liberal, Juan +23 more·2021·Radiology

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 ± 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; 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. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Summers in this issue.

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Crossref · 10.1148/radiol.2021200928

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  • Radiology is one step ahead and shows what is possible with the emerging field of radiomics-the extraction of data from radiograms to diagnose cancer, predict outcomes or guide therapy.

    “Radiology is one step ahead and shows what is possible with the emerging field of radiomics—the extraction of data from radiograms to diagnose cancer, predict outcomes or guide therapy (54–56).”

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Authors
Ligero, M., Garcia-Ruiz, A., Viaplana, C., Villacampa, G., Raciti, M. V., Landa, J., Matos, I., Martin-Liberal, J., Ochoa-de-Olza, M., Hierro, C., Mateo, J., Gonzalez, M., Morales-Barrera, R., Suarez, C., Rodon, J., Elez, E., Braña, I., Muñoz-Couselo, E., Oaknin, A., Fasani, R., Nuciforo, P., Gil, D., Rubio-Perez, C., Seoane, J., Felip, E., Escobar, M., Tabernero, J., Carles, J., Dienstmann, R., Garralda, E., & Perez-Lopez, R.
Affiliations
Universitat Autònoma de Barcelona (ES)
Venue
Radiology
Published
2021-04
Volume
299
Issue
1
Pages
109-119
ISSN
  • 0033-8419 (ISSN-L)
  • 1527-1315
OpenAlex
W3124556679
Cited by
107
References
34
Citations by year
2026: 9 · 2025: 19 · 2024: 22 · 2023: 26 · 2022: 18 · 2021: 10 · 2020: 2 · 2019: 1
FWCI
10.04
Type
journal article
Language
en
Open access
closed
Locations
  • Radiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Banco Bilbao Vizcaya Argentaria (RTI2018-095209-B-C21, FIS-G64384969)
  • Generalitat de Catalunya (2017-SGR-1624)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
Keywords
radiomics signature, immune checkpoint inhibitors, predictive imaging biomarkers, treatment response prediction, advanced solid tumors, PD-1/PD-L1 inhibitors, metastasis, computed tomography, elastic net feature selection, albumin, lymphocyte count, bladder cancer, lung cancer, breast cancer, cervical cancer, gastrointestinal cancer, biomarker validation
MeSH terms
Immune Checkpoint Inhibitors, Aged, Female, Humans, Male, Middle Aged, Neoplasms, Retrospective Studies, Tomography, X-Ray Computed, Biomarkers, Tumor

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