ArticleTranslational lung cancer research2024
Radiomicsmetabolic signature profiles for advanced non-small cell lung cancer with chemoimmunotherapy by reflecting biological function and survival.
Article in Translational lung cancer research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Specific PET Imaging for Precision Management of Lung Cancer: Advances, Clinical Translation and Future Directions.Chemical & biomedical imaging · 2026Review
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12 authors.
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Abstract
Background: Resistance to chemoimmunotherapy in patients with advanced non-small cell lung cancer (NSCLC) necessitates effective prognostic biomarkers. Although Methods: We retrospectively recruited unresectable advanced NSCLC patients receiving immunotherapy in Jinling Hospital from 2018 to 2023 as the training cohort. The Cancer Imaging Archive (TCIA) cohort with early-stage NSCLC patients undergoing surgical resection was used for validation and the assessment of the biological function and tumor microenvironment (TME). PET/CT-based parameters were extracted, including radiomics score (Rad-score), bone marrow to liver ratio (BLR), tMTV, and total lesion glycolysis (TLG). The end-point events included overall survival (OS) and progression-free survival (PFS). Step-wise multivariate Cox regression and the least absolute shrinkage and selection operator (LASSO) were used to identify candidate variables and establish models. Results: A total of 220 patients were identified for analysis, including 139 with unresectable advanced NSCLC receiving immunotherapy and 81 from TCIA. The Radiomicsmetabolicos model for OS encompassing Rad-score >0.705 [hazard ratio (HR) =2.455; 95% confidence interval (CI): 1.324-4.550], squamous cell subtype (HR =1.641; 95% CI: 0.900-2.992), liver metastases (HR =3.496; 95% CI: 1.435-8.517), BLR >0.94 (HR =1.885; 95% CI: 1.013-3.507), and tMTV >105 mL (HR =2.162; 95% CI: 1.134-4.119) exhibited reliable prognostic capacity with a notable 3-year area under the curve (AUC) of 0.837. Patients with Rad-score ≤0.705 demonstrated upregulation of immune-related pathways and favorable survival. Additionally, distant metastases metabolic tumor volume (MTV) and TLG, as well as intrathoracic lymph nodes MTV were associated with survival independently. For patients with similar tMTV (≤105 mL), the number of FDG-avid lesions was an independent protective factor for more-than-1-year OS, which indicated that patients with smaller lesions seemed to have better long-term prognoses than those with larger lesions, even of fewer in number. Conclusions: Our findings proved that PET/CT could reveal survival and tumor heterogeneity in advanced NSCLC patients undergoing chemoimmunotherapy, which might guide the selection of immune-monotherapy for low-risk patients and facilitate the advancement of precision treatment.
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