Evidence map›Paper›PMID 41749806›Full record

ArticleCancers2026

Multi-Institutional CT Scan-Based Radiomics for Predicting Tumor PD-L1 Expression in Patients with Advanced and Limited Non-Small Cell Lung Cancer.

Ralph Saber, Marion Tonneau, Olivier Salko, Moishe Liberman, Julie Malo, Arielle Elkrief, Simon Turcotte, Nicole Bouchard, Philippe Joubert, Samuel Kadoury and 1 more

Abstract read
In one paragraph

Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ralph SaberMedICAL Laboratory, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada.
Marion TonneauResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.
Olivier SalkoResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.
Moishe LibermanResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.ORCID 0000-0002-9964-1232
Julie MaloResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.ORCID 0009-0005-3613-2210
Arielle ElkriefResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.
Simon TurcotteResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.
Nicole BouchardHospital Center of the University of Sherbrooke, Sherbrooke, QC J1G 1B1, Canada.ORCID 0000-0002-5222-6904
Philippe JoubertUniversity Institute of Cardiology and Pneumology of Quebec, Laval University, Quebec City, QC G1V 0A6, Canada.ORCID 0000-0001-7784-6387
Samuel KadouryMedICAL Laboratory, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada.
Bertrand RoutyResearch Center of the Hospital Center of the University of Montreal, Montreal, QC H2X 0A9, Canada.

Funding

Fonds de recherche du Québec - Nature et Technologie N/AFonds de Recherche du Québec - Santé N/AInstitut du Cancer du Poumon N/ANatural Sciences and Engineering Research Council of Canada N/AOncotech grant N/AQuebec Respiratory Health Research Network N/ATrans-MedTech Institute N/A
6 · The paper itself

Abstract

BACKGROUND/

objectivesImmune checkpoint inhibitors (ICIs) have revolutionized the treatment landscape of advanced non-small cell lung cancer (NSCLC), yet 70% of patients experience disease progression, underscoring the critical need for predictive biomarkers. Programmed death-ligand 1 (PD-L1) expression remains the most adopted biomarker for ICIs. With the emergence of machine learning, the development of radiomics algorithms based on CT scan images has demonstrated potential as a novel addition to the biomarker landscape in oncology. In this study, we aimed to develop a non-invasive surrogate of PD-L1 expression (rad-PDL1) derived from computed tomography (CT) scan imaging and compare its predictive value to pathological assessments. Furthermore, we evaluated its generalizability across advanced and limited-stage NSCLC.

methodsRadiomics features extracted from pretreatment CT were analyzed using a self-training pipeline that incorporated the feature tokenizer Transformer model to classify tumors as high vs. low PD-L1 expression. We included 482 advanced NSCLC patients treated with ICIs across three medical centers who were divided into training and hold-out validation sets. The algorithm was then further validated in an independent cohort of 51 patients with limited NSCLC treated with neoadjuvant ICI and chemotherapy.

resultsOur pipeline demonstrated strong predictive performance in primary and independent validation (AUC = 0.75 and 0.68, accuracy = 0.73 and 0.69, respectively), highlighting its generalizability and adaptability to various disease stages. Kaplan-Meier curves revealed a longer progression-free survival for patients in the high rad-PDL1.

conclusionsThese results demonstrate the feasibility of a CT-based radiomic surrogate of PD-L1 expression, showing partial generalization to an independent neoadjuvant cohort, while highlighting the need for larger prospective multi-site validation before clinical implementation.

Indexed as

immune checkpoint blockadenoninvasive biomarkernon-small cell lung cancerprogrammed death-ligand 1radiomics

Identifiers

PMID41749806
PMCPMC12939105

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.