Application of Radiomics in Prognosing Lung Cancer Treated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Systematic Review and Meta-Analysis

Abstract

In the context of non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs), this research evaluated the prognostic value of CT-based radiomics. A comprehensive systematic review and meta-analysis of studies up to April 2023, which included 3111 patients, was conducted. We utilized the Quality in Prognosis Studies (QUIPS) tool and radiomics quality scoring (RQS) system to assess the quality of the included studies. Our analysis revealed a pooled hazard ratio for progression-free survival of 2.80 (95% confidence interval: 1.87–4.19), suggesting that patients with certain radiomics features had a significantly higher risk of disease progression. Additionally, we calculated the pooled Harrell’s concordance index and area under the curve (AUC) values of 0.71 and 0.73, respectively, indicating good predictive performance of radiomics. Despite these promising results, further studies with consistent and robust protocols are needed to confirm the prognostic role of radiomics in NSCLC.

Progress in Serial Imaging for Prognostic Stratification of Lung Cancer Patients Receiving Immunotherapy: A Systematic Review and Meta-Analysis

“…In our systemic review, a limited number of studies have interpreted the selected radiomic parameters in prediction models, echoing similar findings in other meta-analyses [43][44][45] focusing on radiomics predicting lung cancer prognosis. Despite radiomics being derived from images, understanding the significance of calculations is crucial.…”

“…Our meta-analysis further extends the landscape to delta radiomics and multi-omic models. Compared to our previous meta-analysis about the application of radiomics in prognosing lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) [45], the quality of the studies about immunotherapy was better, except in the study-confounding domain. The mean RQS was 13.5 in studies about immunotherapy and 11.67 in studies about EGFR-TKI, both indicating a moderate level of quality.…”