RT Journal Article
SR Electronic
T1 Radiomics to predict outcomes and abscopal response of patients with cancer treated with immunotherapy combined with radiotherapy using a validated signature of CD8 cells
JF Journal for ImmunoTherapy of Cancer
JO J Immunother Cancer
FD BMJ Publishing Group Ltd
SP e001429
DO 10.1136/jitc-2020-001429
VO 8
IS 2
A1 Roger Sun
A1 Nora Sundahl
A1 Markus Hecht
A1 Florian Putz
A1 Andrea Lancia
A1 Angela Rouyar
A1 Marina Milic
A1 Alexandre Carré
A1 Enzo Battistella
A1 Emilie Alvarez Andres
A1 Stéphane Niyoteka
A1 Edouard Romano
A1 Guillaume Louvel
A1 Jérôme Durand-Labrunie
A1 Sophie Bockel
A1 Rastilav Bahleda
A1 Charlotte Robert
A1 Celine Boutros
A1 Maria Vakalopoulou
A1 Nikos Paragios
A1 Benjamin Frey
A1 Jean-Charles Soria
A1 Christophe Massard
A1 Charles Ferté
A1 Rainer Fietkau
A1 Piet Ost
A1 Udo Gaipl
A1 Eric Deutsch
YR 2020
UL http://jitc.bmj.com/content/8/2/e001429.abstract
AB Background Combining radiotherapy (RT) with immuno-oncology (IO) therapy (IORT) may enhance IO-induced antitumor response. Quantitative imaging biomarkers can be used to provide prognosis, predict tumor response in a non-invasive fashion and improve patient selection for IORT. A biologically inspired CD8 T-cells-associated radiomics signature has been developed on previous cohorts. We evaluated here whether this CD8 radiomic signature is associated with lesion response, whether it may help to assess disease spatial heterogeneity for predicting outcomes of patients treated with IORT. We also evaluated differences between irradiated and non-irradiated lesions.Methods Clinical data from patients with advanced solid tumors in six independent clinical studies of IORT were investigated. Immunotherapy consisted of 4 different drugs (antiprogrammed death-ligand 1 or anticytotoxic T-lymphocyte-associated protein 4 in monotherapy). Most patients received stereotactic RT to one lesion. Irradiated and non-irradiated lesions were delineated from baseline and the first evaluation CT scans. Radiomic features were extracted from contrast-enhanced CT images and the CD8 radiomics signature was applied. A responding lesion was defined by a decrease in lesion size of at least 30%. Dispersion metrices of the radiomics signature were estimated to evaluate the impact of tumor heterogeneity in patient’s response.Results A total of 94 patients involving multiple lesions (100 irradiated and 189 non-irradiated lesions) were considered for a statistical interpretation. Lesions with high CD8 radiomics score at baseline were associated with significantly higher tumor response (area under the receiving operating characteristic curve (AUC)=0.63, p=0.0020). Entropy of the radiomics scores distribution on all lesions was shown to be associated with progression-free survival (HR=1.67, p=0.040), out-of-field abscopal response (AUC=0.70, p=0.014) and overall survival (HR=2.08, p=0.023), which remained significant in a multivariate analysis including clinical and biological variables.Conclusions These results enhance the predictive value of the biologically inspired CD8 radiomics score and suggests that tumor heterogeneity should be systematically considered in patients treated with IORT. This CD8 radiomics signature may help select patients who are most likely to benefit from IORT.