Computed tomography-derived radiomic metrics can identify responders to immunotherapy in ovarian cancer Journal Article
| Authors: | Himoto, Y.; Veeraraghavan, H.; Zheng, J.; Zamarin, D.; Snyder, A.; Capanu, M.; Nougaret, S.; Vargas, H. A.; Shitano, F.; Callahan, M.; Wang, W.; Sala, E.; Lakhman, Y. |
| Article Title: | Computed tomography-derived radiomic metrics can identify responders to immunotherapy in ovarian cancer |
| Abstract: | PURPOSE To determine if radiomic measures of tumor heterogeneity derived from baseline contrast-enhanced computed tomography (CE-CT) are associated with durable clinical benefit and time to off-treatment in patients with recurrent ovarian cancer (OC) enrolled in prospective immunotherapeutic trials. MATERIALS AND METHODS This retrospective study included 75 patients with recurrent OC who were enrolled in prospective immunotherapeutic trials (n = 74) or treated off-label (n = 1) and had baseline CE-CT scans. Disease burden (total tumor volume, number of disease sites), radiomic measures of intertumor heterogeneity (clustersite entropy, cluster-site dissimilarity), and intratumor heterogeneity of the largest lesion (Haralick texture features) were computed. Associations of clinical, conventional imaging, and radiomic measures with durable clinical benefit and time to off-treatment were examined. RESULTS In univariable analysis, fewer disease sites, lower intertumor heterogeneity (lower cluster-site entropy, lower cluster-site dissimilarity), and lower intratumor heterogeneity of the largest lesion (higher energy) were significantly associated with durable clinical benefit (P ≤ .031). More disease sites, presence of pleural disease and/or distant metastases, higher intertumor heterogeneity (higher cluster-site entropy, higher cluster-site dissimilarity), and higher intratumor heterogeneity of the largest lesion (higher Contrastlargest-lesion) were significantly associated with shorter time to off-treatment (P ≤ .034). Inmultivariable analysis, higher Energylargest-lesion (indicator of lower intratumor heterogeneity; P = .006; odds ratio, 1.41) and fewer disease sites (P = .003; odds ratio, 1.64) remained significant indicators of durable clinical benefit (multivariablemodel C-index, 0.821). Higher cluster-site dissimilarity (indicator of higher intertumor heterogeneity) was a modest but single independent indicator of shorter time to off-treatment (P = .004; hazard ratio, 1.19; C-index, 0.6). CONCLUSION Fewer disease sites and lower intra- and intertumor heterogeneity modeled from the baseline CE-CT may indicate better response of OC to immunotherapy. © 2019 by American Society of Clinical Oncology. |
| Keywords: | adult; aged; major clinical study; overall survival; clinical feature; cancer recurrence; cancer staging; prospective study; cancer immunotherapy; progression free survival; computer assisted tomography; ovary cancer; tumor volume; retrospective study; distant metastasis; genetic heterogeneity; programmed death 1 ligand 1; programmed death 1 receptor; tumor microenvironment; pleura disease; clinical outcome; contrast-enhanced ultrasound; international federation of gynecology and obstetrics; off label drug use; entropy; human; female; priority journal; article; radiomics; immunological antineoplastic agent; k means clustering; cluster site entropy |
| Journal Title: | JCO Precision Oncology |
| Volume: | 3 |
| ISSN: | 2473-4284 |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2019-12-01 |
| Language: | English |
| DOI: | 10.1200/po.19.00038 |
| PROVIDER: | scopus |
| PMCID: | PMC7446503 |
| PUBMED: | 32914033 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Yulia Lakhman -- Source: Scopus |
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