Changes in CT Radiomic Features Associated with Lymphocyte Distribution Predict Overall Survival and Response to Immunotherapy in Non-Small Cell Lung Cancer.

TitleChanges in CT Radiomic Features Associated with Lymphocyte Distribution Predict Overall Survival and Response to Immunotherapy in Non-Small Cell Lung Cancer.
Publication TypeJournal Article
Year of Publication2020
AuthorsKhorrami M, Prasanna P, Gupta A, Patil P, Velu PD, Thawani R, Corredor G, Alilou M, Bera K, Fu P, Feldman M, Velcheti V, Madabhushi A
JournalCancer Immunol Res
Volume8
Issue1
Pagination108-119
Date Published2020 Jan
ISSN2326-6074
Abstract

No predictive biomarkers can robustly identify patients with non-small cell lung cancer (NSCLC) who will benefit from immune checkpoint inhibitor (ICI) therapies. Here, in a machine learning setting, we compared changes ("delta") in the radiomic texture (DelRADx) of CT patterns both within and outside tumor nodules before and after two to three cycles of ICI therapy. We found that DelRADx patterns could predict response to ICI therapy and overall survival (OS) for patients with NSCLC. We retrospectively analyzed data acquired from 139 patients with NSCLC at two institutions, who were divided into a discovery set (D = 50) and two independent validation sets (D = 62, D = 27). Intranodular and perinodular texture descriptors were extracted, and the relative differences were computed. A linear discriminant analysis (LDA) classifier was trained with 8 DelRADx features to predict RECIST-derived response. Association of delta-radiomic risk score (DRS) with OS was determined. The association of DelRADx features with tumor-infiltrating lymphocyte (TIL) density on the diagnostic biopsies ( = 36) was also evaluated. The LDA classifier yielded an AUC of 0.88 ± 0.08 in distinguishing responders from nonresponders in D, and 0.85 and 0.81 in D and D DRS was associated with OS [HR: 1.64; 95% confidence interval (CI), 1.22-2.21; = 0.0011; C-index = 0.72). Peritumoral Gabor features were associated with the density of TILs on diagnostic biopsy samples. Our results show that DelRADx could be used to identify early functional responses in patients with NSCLC.

DOI10.1158/2326-6066.CIR-19-0476
Alternate JournalCancer Immunol Res
PubMed ID31719058
Grant ListR01 CA216579 / CA / NCI NIH HHS / United States
R01 CA202752 / CA / NCI NIH HHS / United States
R01 CA208236 / CA / NCI NIH HHS / United States
U24 CA199374 / CA / NCI NIH HHS / United States
I01 BX004121 / BX / BLRD VA / United States
R01 CA220581 / CA / NCI NIH HHS / United States