@Article{MartaLigero2021,
author="Marta Ligero
and Alonso Garcia Ruiz
and Cristina Viaplana
and Guillermo Villacampa
and Maria V Raciti
and Jaid Landa
and Ignacio Matos
and Juan Martin Liberal
and Maria Ochoa de Olza
and Cinta Hierro
and Joaquin Mateo
and Macarena Gonzalez
and Rafael Morales Barrera
and Cristina Suarez
and Jordi Rodon
and Elena Elez
and Irene Bra{\~n}a
and Eva Mu{\~n}oz-Couselo
and Ana Oaknin
and Roberta Fasani
and Paolo Nuciforo
and Debora Gil
and Carlota Rubio Perez
and Joan Seoane
and Enriqueta Felip
and Manuel Escobar
and Josep Tabernero
and Joan Carles
and Rodrigo Dienstmann
and Elena Garralda
and Raquel Perez Lopez",
title="A CT-based radiomics signature is associated with response to immune checkpoint inhibitors in advanced solid tumors",
journal="Radiology",
year="2021",
volume="299",
number="1",
pages="109--119",
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 {\textpm} 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years {\textpm} 12; 37 men) and 47 patients (cohort 3: mean age, 64 years {\textpm} 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years {\textpm} 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. {\textcopyright} RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Summers in this issue.",
optnote="IAM; 600.145",
optnote="exported from refbase (http://refbase.cvc.uab.es/show.php?record=3593), last updated on Tue, 23 Nov 2021 16:15:04 +0100",
doi="10.1148/radiol.2021200928",
opturl="https://pubs.rsna.org/doi/10.1148/radiol.2021200928"
}