Radiomics-based prediction model for outcomes of PD-1/PD-L1 immunotherapy in metastatic urothelial carcinoma
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Radiomics-based prediction model for outcomes of PD-1/PD-L1 immunotherapy in metastatic urothelial carcinoma Kye Jin Park 1 & Jae-Lyun Lee 2 & Shin-Kyo Yoon 2 & Changhoe Heo 3 & Bum Woo Park 3 & Jeong Kon Kim 1 Received: 22 January 2020 / Revised: 27 February 2020 / Accepted: 30 March 2020 # European Society of Radiology 2020
Abstract Objectives To evaluate the usefulness of a radiomics-based prediction model for predicting response and survival outcomes of patients with metastatic urothelial carcinoma treated with immunotherapy targeting programmed cell death 1 (PD-1) and its ligand (PD-L1). Methods Sixty-two patients who underwent immunotherapy were divided into training (n = 41) and validation sets (n = 21). A total of 224 measurable lesions were identified on contrast-enhanced CT. A radiomics signature was constructed with features selected using a least absolute shrinkage and selection operator algorithm in the training set. A radiomics-based model was built based on a radiomics signature consisting of five reliable RFs and the presence of visceral organ involvement using multivariate logistic regression. According to a cutoff determined on the training set, patients in the validation set were assigned to either high- or low-risk groups. Kaplan-Meier analysis was performed to compare progression-free and overall survival between high- and low-risk groups. Results For predicting objective response and disease control, the areas under the receiver operating characteristic curves of the radiomics-based model were 0.87 (95% CI, 0.65–0.97) and 0.88 (95% CI, 0.67–0.98) for the validation set, providing larger net benefit determined by decision curve analysis than without radiomics-based model. The high-risk group in the validation set showed shorter progression-free and overall survival than the low-risk group (log-rank p = 0.044 and p = 0.035). Conclusions The radiomics-based model may predict the response and survival outcome in patients treated with PD-1/PD-L1 immunotherapy for metastatic urothelial carcinoma. This approach may provide important and decision tool for planning immunotherapy. Key Points • A radiomics-based model was built based on radiomics features and the presence of visceral organ involvement for prediction of outcomes in metastatic urothelial carcinoma treated with immunotherapy. • This prediction model demonstrated good prediction of treatment response and higher net benefit than no model in the independent validation set. • This radiomics-based model demonstrated significant associations with progression-free and overall survival between low-risk and high-risk groups. Keywords Immunotherapy . Urinary bladder neoplasms . Urologic neoplasms Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-06847-0) contains supplementary material, which is available to authorized users. * Jeong Kon Kim [email protected] 1
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-g
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