ArticlePloS one2018
Intratumoral heterogeneity characterized by pretreatment PET in non-small cell lung cancer patients predicts progression-free survival on EGFR tyrosine kinase inhibitor.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Future of Cancer Diagnosis, Treatment and Surveillance: A Systemic Review on Immunotherapy and Immuno-PET Radiotracers.Molecules (Basel, Switzerland) · 2021Pooled it
- Tumor metabolic heterogeneity based onBMC cancer · 2025Article
- A narrative review of imaging intratumor heterogeneity in non-small cell lung cancer: current advances.Translational lung cancer research · 2025Review
- Machine Learning and Texture Analysis of [Biomedicines · 2024Article
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- Heterogeneity of Glycolytic Phenotype Determined byDiagnostics (Basel, Switzerland) · 2023Article
- Radiomic and Volumetric Measurements as Clinical Trial Endpoints-A Comprehensive Review.Cancers · 2022Review
- A deep learning-based system for survival benefit prediction of tyrosine kinase inhibitors and immune checkpoint inhibitors in stage IV non-small cell lung cancer patients: A multicenter, prognostic study.EClinicalMedicine · 2022Article
- Article
- Radiomics in Oncological PET Imaging: A Systematic Review-Part 1, Supradiaphragmatic Cancers.Diagnostics (Basel, Switzerland) · 2022Review
- Tumor glycolytic heterogeneity improves detection of regional nodal metastasis in patients with lung adenocarcinoma.Annals of nuclear medicine · 2022Article
- Advantages and Applications of Total-Body PET Scanning.Diagnostics (Basel, Switzerland) · 2022Review
- Article
- Association of androgen receptor expression with glucose metabolic features in triple-negative breast cancer.PloS one · 2022Article
- Intratumor heterogeneity of driver mutations and TMB distribution in 30 early-stage LUAD patients with multiple lesions.Frontiers in oncology · 2022Article
- A Review of the Correlation Between Epidermal Growth Factor Receptor Mutation Status andFrontiers in oncology · 2022Review
- Recent and current advances in PET/CT imaging in the field of predicting epidermal growth factor receptor mutations in non-small cell lung cancer.Frontiers in oncology · 2022Review
- Two-Year Event-Free Survival Prediction in DLBCL Patients Based onFrontiers in oncology · 2022Article
- Application of Radiomics and Artificial Intelligence for Lung Cancer Precision Medicine.Cold Spring Harbor perspectives in medicine · 2021Review
- Is FDG-PET texture analysis related to intratumor biological heterogeneity in lung cancer?European radiology · 2021Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Intratumoral heterogeneity has been suggested to be an important resistance mechanism leading to treatment failure. We hypothesized that radiologic images could be an alternative method for identification of tumor heterogeneity. We tested heterogeneity textural parameters on pretreatment FDG-PET/CT in order to assess the predictive value of target therapy. Recurred or metastatic non-small cell lung cancer (NSCLC) subjects with an activating EGFR mutation treated with either gefitinib or erlotinib were reviewed. An exploratory data set (n = 161) and a validation data set (n = 21) were evaluated, and eight parameters were selected for survival analysis. The optimal cutoff value was determined by the recursive partitioning method, and the predictive value was calculated using Harrell's C-index. Univariate analysis revealed that all eight parameters showed an increased hazard ratio (HR) for progression-free survival (PFS). The highest HR was 6.41 (P<0.01) with co-occurrence (Co) entropy. Increased risk remained present after adjusting for initial stage, performance status (PS), and metabolic volume (MV) (aHR: 4.86, P<0.01). Textural parameters were found to have an incremental predictive value of early EGFR tyrosine kinase inhibitor (TKI) failure compared to that of the base model of the stage and PS (C-index 0.596 vs. 0.662, P = 0.02, by Co entropy). Heterogeneity textural parameters acquired from pretreatment FDG-PET/CT are highly predictive factors for PFS of EGFR TKI in EGFR-mutated NSCLC patients. These parameters are easily applicable to the identification of a subpopulation at increased risk of early EGFR TKI failure. Correlation to genomic alteration should be determined in future studies.
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