Radiomic-signature changes after early treatment improve the prediction of progression-free survival in patients with advanced anaplastic lymphoma kinase-positive non-small cell lung cancer

Author:

Hou Donghui1,Zheng Xiaomin2,Song Wei3,Liu Xiaoqing4,Wang Sicong5,Zhou Lina1,Tao Xiuli6,Lv Lv6,Sun Qi7,Jin Yujing6,Zhang Zewei6,Ding Lieming8,Wu Ning16,Zhao Shijun1ORCID

Affiliation:

1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China

2. Department of Endocrinology, Chui Yang Liu Hospital affiliated to Tsinghua University, Beijing, PR China

3. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China

4. Department of Pulmonary Oncology, the Fifth Medical Centre, Chinese PLA General Hospital, Beijing, China

5. Life Sciences, GE Healthcare, Beijing, PR China

6. PET-CT Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China

7. Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, PR China

8. Betta Pharmaceuticals Co., Ltd, Hangzhou, PR China

Abstract

Background The prognosis of lung cancer varies widely, even in cases wherein the tumor stage, genetic mutation, and treatment regimens are the same. Thus, an effective means for risk stratification of patients with lung cancer is needed. Purpose To develop and validate a combined model for predicting progression-free survival and risk stratification in patients with advanced anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) treated with ensartinib. Material and Methods We analyzed 203 tumor lesions in 114 patients and evaluated average radiomic feature measures from all lesions at baseline and changes in these features after early treatment (Δradiomic features). Combined models were developed by integrating clinical with radiomic features. The prediction performance and clinical value of the proposed models were evaluated using receiver operating characteristic analysis, calibration curve, decision curve analysis (DCA), and Kaplan–Meier survival analysis. Results Both the baseline and delta combined models achieved predictive efficacy with a high area under the curve. The calibration curve and DCA indicated the high accuracy and clinical usefulness of the combined models for tumor progression prediction. In the Kaplan–Meier analysis, the delta and baseline combined models, Δradiomic signature, and two selected clinical features could distinguish patients with a higher progression risk within 42 weeks. The delta combined model had the best performance. Conclusion The combination of clinical and radiomic features provided a prognostic value for survival and progression in patients with NSCLC receiving ensartinib. Radiomic-signature changes after early treatment could be more valuable than those at baseline alone.

Funder

Beijing Municipal Science and Technology Project

CAMS Innovation Fund for Medical Sciences

National Natural Science Foundation of China

National Key R&D Program of China

Publisher

SAGE Publications

Subject

Radiology, Nuclear Medicine and imaging,General Medicine,Radiological and Ultrasound Technology

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