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Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Computed Tomography | Research

Predicting response to immunotherapy plus chemotherapy in patients with esophageal squamous cell carcinoma using non-invasive Radiomic biomarkers

Authors: Ying Zhu, Wang Yao, Bing-Chen Xu, Yi-Yan Lei, Qi-Kun Guo, Li-Zhi Liu, Hao-Jiang Li, Min Xu, Jing Yan, Dan-Dan Chang, Shi-Ting Feng, Zhi-Hua Zhu

Published in: BMC Cancer | Issue 1/2021

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Abstract

Objectives

To develop and validate a radiomics model for evaluating treatment response to immune-checkpoint inhibitor plus chemotherapy (ICI + CT) in patients with advanced esophageal squamous cell carcinoma (ESCC).

Methods

A total of 64 patients with advance ESCC receiving first-line ICI + CT at two centers between January 2019 and June 2020 were enrolled in this study. Both 2D ROIs and 3D ROIs were segmented. ComBat correction was applied to minimize the potential bias on the results due to different scan protocols. A total of 788 features were extracted and radiomics models were built on corrected/uncorrected 2D and 3D features by using 5-fold cross-validation. The performance of the radiomics models was assessed by its discrimination, calibration and clinical usefulness with independent validation.

Results

Five features and support vector machine algorithm were selected to build the 2D uncorrected, 2D corrected, 3D uncorrected and 3D corrected radiomics models. The 2D radiomics models significantly outperformed the 3D radiomics models in both primary and validation cohorts. When ComBat correction was used, the performance of 2D models was better (p = 0.0059) in the training cohort, and significantly better (p < 0.0001) in the validation cohort. The 2D corrected radiomics model yielded the optimal performance and was used to build the nomogram. The calibration curve of the radiomics model demonstrated good agreement between prediction and observation and the decision curve analysis confirmed the clinical utility.

Conclusions

The easy-to-use 2D corrected radiomics model could facilitate noninvasive preselection of ESCC patients who would benefit from ICI + CT.
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Literature
5.
go back to reference Short MW, Burgers KG, Fry VT. Esophageal Cancer. Am Fam Physician. 2017;95(1):22–8.PubMed Short MW, Burgers KG, Fry VT. Esophageal Cancer. Am Fam Physician. 2017;95(1):22–8.PubMed
10.
go back to reference Ott PA, Bang YJ, Piha-Paul SA, Razak ARA, Bennouna J, Soria JC, et al. T-Cell-Inflamed Gene-Expression Profile, Programmed Death Ligand 1 Expression, and Tumor Mutational Burden Predict Efficacy in Patients Treated With Pembrolizumab Across 20 Cancers: KEYNOTE-028. J Clin Oncol. 2019;37(4):318–27. https://doi.org/10.1200/JCO.2018.78.2276.CrossRef Ott PA, Bang YJ, Piha-Paul SA, Razak ARA, Bennouna J, Soria JC, et al. T-Cell-Inflamed Gene-Expression Profile, Programmed Death Ligand 1 Expression, and Tumor Mutational Burden Predict Efficacy in Patients Treated With Pembrolizumab Across 20 Cancers: KEYNOTE-028. J Clin Oncol. 2019;37(4):318–27. https://​doi.​org/​10.​1200/​JCO.​2018.​78.​2276.CrossRef
11.
go back to reference Shah MA, Kojima T, Hochhauser D, Enzinger P, Raimbourg J, Hollebecque A, et al. Efficacy and safety of Pembrolizumab for heavily pretreated patients with advanced, metastatic adenocarcinoma or squamous cell carcinoma of the esophagus: the phase 2 KEYNOTE-180 study. JAMA Oncol. 2019;5(4):546–50. https://doi.org/10.1001/jamaoncol.2018.5441.CrossRef Shah MA, Kojima T, Hochhauser D, Enzinger P, Raimbourg J, Hollebecque A, et al. Efficacy and safety of Pembrolizumab for heavily pretreated patients with advanced, metastatic adenocarcinoma or squamous cell carcinoma of the esophagus: the phase 2 KEYNOTE-180 study. JAMA Oncol. 2019;5(4):546–50. https://​doi.​org/​10.​1001/​jamaoncol.​2018.​5441.CrossRef
15.
go back to reference Bando H, Kotani D, Tsushima T, Hara H, Kadowaki S, Kato Ke, Chin K, Yamaguchi K, Kageyama SI, Hojo H, Nakamura M, Tachibana H, Wakabayashi M, Fukutani M, Togashi Y, Fuse N, Nishikawa H, Kojima T TENERGY: multicenter phase II study of Atezolizumab monotherapy following definitive Chemoradiotherapy with 5-FU plus cisplatin in patients with unresectable locally advanced esophageal squamous cell carcinoma. BMC Cancer 2020;20(1):336. https://doi.org/10.1186/s12885-020-06716-5. Bando H, Kotani D, Tsushima T, Hara H, Kadowaki S, Kato Ke, Chin K, Yamaguchi K, Kageyama SI, Hojo H, Nakamura M, Tachibana H, Wakabayashi M, Fukutani M, Togashi Y, Fuse N, Nishikawa H, Kojima T TENERGY: multicenter phase II study of Atezolizumab monotherapy following definitive Chemoradiotherapy with 5-FU plus cisplatin in patients with unresectable locally advanced esophageal squamous cell carcinoma. BMC Cancer 2020;20(1):336. https://​doi.​org/​10.​1186/​s12885-020-06716-5.
16.
go back to reference Fuchs CS, Doi T, Jang RW, Muro K, Satoh T, Machado M, et al. Safety and Efficacy of Pembrolizumab Monotherapy in Patients with Previously Treated Advanced Gastric and Gastroesophageal Junction Cancer: Phase 2 Clinical KEYNOTE-059 Trial. 2018;4(5):e180013. https://doi.org/10.1001/jamaoncol.2018.0013. Fuchs CS, Doi T, Jang RW, Muro K, Satoh T, Machado M, et al. Safety and Efficacy of Pembrolizumab Monotherapy in Patients with Previously Treated Advanced Gastric and Gastroesophageal Junction Cancer: Phase 2 Clinical KEYNOTE-059 Trial. 2018;4(5):e180013. https://​doi.​org/​10.​1001/​jamaoncol.​2018.​0013.
18.
go back to reference Sun R, Sundahl N, Hecht M, Putz F, Lancia A, Rouyar A, et al. Radiomics to predict outcomes and abscopal response of patients with cancer treated with immunotherapy combined with radiotherapy using a validated signature of CD8 cells. J Immunother Cancer. 2020;8(2):e001429. https://doi.org/10.1136/jitc-2020-001429. Sun R, Sundahl N, Hecht M, Putz F, Lancia A, Rouyar A, et al. Radiomics to predict outcomes and abscopal response of patients with cancer treated with immunotherapy combined with radiotherapy using a validated signature of CD8 cells. J Immunother Cancer. 2020;8(2):e001429. https://​doi.​org/​10.​1136/​jitc-2020-001429.
29.
go back to reference Ligero M, Jordi-Ollero O, Bernatowicz K, Garcia-Ruiz A, Delgado-Munoz E, Levia D, et al. Minimizing acquisition-related radiomics variability by image resampling and batch effect correction to allow for large- scale data analysis. Eur Radiol. 2021;31(3):1460–70. https://doi.org/10.1007/s00330-020-07174-0.  Ligero M, Jordi-Ollero O, Bernatowicz K, Garcia-Ruiz A, Delgado-Munoz E, Levia D, et al. Minimizing acquisition-related radiomics variability by image resampling and batch effect correction to allow for large- scale data analysis. Eur Radiol. 2021;31(3):1460–70. https://​doi.​org/​10.​1007/​s00330-020-07174-0.
Metadata
Title
Predicting response to immunotherapy plus chemotherapy in patients with esophageal squamous cell carcinoma using non-invasive Radiomic biomarkers
Authors
Ying Zhu
Wang Yao
Bing-Chen Xu
Yi-Yan Lei
Qi-Kun Guo
Li-Zhi Liu
Hao-Jiang Li
Min Xu
Jing Yan
Dan-Dan Chang
Shi-Ting Feng
Zhi-Hua Zhu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-08899-x

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