TY  - JOUR
AU  - Marta Ligero
AU  - Alonso Garcia Ruiz
AU  - Cristina Viaplana
AU  - Guillermo Villacampa
AU  - Maria V Raciti
AU  - Jaid Landa
AU  - Ignacio Matos
AU  - Juan Martin Liberal
AU  - Maria Ochoa de Olza
AU  - Cinta Hierro
AU  - Joaquin Mateo
AU  - Macarena Gonzalez
AU  - Rafael Morales Barrera
AU  - Cristina Suarez
AU  - Jordi Rodon
AU  - Elena Elez
AU  - Irene Braña
AU  - Eva Muñoz-Couselo
AU  - Ana Oaknin
AU  - Roberta Fasani
AU  - Paolo Nuciforo
AU  - Debora Gil
AU  - Carlota Rubio Perez
AU  - Joan Seoane
AU  - Enriqueta Felip
AU  - Manuel Escobar
AU  - Josep Tabernero
AU  - Joan Carles
AU  - Rodrigo Dienstmann
AU  - Elena Garralda
AU  - Raquel Perez Lopez
PY  - 2021//
TI  - A CT-based radiomics signature is associated with response to immune checkpoint inhibitors in advanced solid tumors
JO  - Radiology
SP  - 109
EP  - 119
VL  - 299
IS  - 1
N2  - 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.
UR  - https://pubs.rsna.org/doi/10.1148/radiol.2021200928
UR  - http://dx.doi.org/10.1148/radiol.2021200928
N1  - IAM; 600.145
ID  - Marta Ligero2021
ER  -