Systematic review of radiomic biomarkers for predicting immune checkpoint inhibitor treatment outcomes

Zhang, Chong; Fonseca, Louise de A. F.; Shi, Zhenwei; Zhu, Cheng; Dekker, André; Bermejo, Iñigo; Wee, Leonard

doi:10.1016/j.ymeth.2020.11.005

Cited by 19 publications

(15 citation statements)

References 45 publications

(140 reference statements)

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“…Additionally, the recognition of these potential adverse effects is an important step towards further investigating and conducting additional prospective studies to gain better insight regarding this class of drugs and their side effect profiles. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

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Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

et al. 2021

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Background and aims: Anti-neoplastic immunotherapy has revolutionized cancer management; however. its safety profile with respect to liver-related injury remains largely unexplored. Herein, we analyzed a United States national database to determine the incidence, mortality, and predictors of hepatotoxicity in the setting of anti-neoplastic immunotherapy. Methods: This was a nationwide retrospective study of hospital encounters from 2011 to 2014 using the National Inpatient Sample (NIS) database. We utilized the International Classification of Diseases, Ninth Revision (ICD-9) coding system to identify all adult patients who underwent anti-neoplastic immunotherapy during hospitalization. The primary outcome was the incidence of hepatotoxicity during the same hospitalization. Secondary outcomes included in-hospital mortality as well as socioeconomic and ethno-racial predictors of hepatotoxicity. Analyses were performed using IBM SPSS Statistics 23.0. Results: The sample included 3002 patients who underwent inpatient anti-neoplastic immunotherapy. The incidence of hepatotoxicity was 10.1%, which was significantly higher as compared to a matched inpatient population (adjusted odds ratio (aOR) 4.93, 95% confidence interval (CI): 3.80–6.40. P = 0.001). No significant mortality difference was seen in those that developed hepatotoxicity compared to those who did not (aOR 0.47. 95% CI: 0.03–8.03, P = 0.612). Age under 60 (aOR 1.56. 95% CI: 123–1.78, P = 0.050) and white race (aOR 1.85. 95% CI: 1.35–2.04, P <0.010) were independent risk factors for developing immunotherapy-associated hepatotoxicity. Conclusions: In this large, nationwide database analysis, we found that anti-neoplastic immunotherapy was associated with a nearly five-fold risk of in-hospital hepatotoxicity as compared to a matched inpatient population, though without an associated mortality difference. Additionally, younger age and white race were identified as predictors of immunotherapy-associated hepatotoxicity. Heightened vigilance and prospective investigation of the risk factors and liver-related adverse effects of anti-neoplastic immunotherapy are warranted.

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Section: Discussionmentioning

confidence: 99%

“… 12 – 14 These risk factors, as well as the other risk factors elucidated by our study should be considered when determining a specific medication regimen for cancer patients. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

et al. 2021

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“…Due to the growing need to identify useful biomarkers to select the patients who are most likely to benefit from ICIs, the quantitative analysis of imaging features by artificial intelligence algorithms, namely radiomics, has recently been investigated as a possible surrogate marker to predict the outcome of patients treated with immunotherapy [ 107 , 108 ]. Radiomics has been reported as a promising approach to predict the response and survival outcomes in patients with NSCLC and melanoma receiving ICIs [ 109 , 110 ]. Three retrospective analyses investigated radiomics from baseline contrast-enhanced computed tomography (CT) images in patients with mUC receiving anti-PDL1 or anti-PD1 monotherapy [ 111 , 112 , 113 ].…”

Section: Radiomicsmentioning

confidence: 99%

Prognostic and Predictive Factors in Advanced Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors: A Review of the Current Evidence

Rebuzzi

Banna

Murianni

et al. 2021

Cancers

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In recent years, the treatment landscape of urothelial carcinoma has significantly changed due to the introduction of immune checkpoint inhibitors (ICIs), which are the standard of care for second-line treatment and first-line platinum-ineligible patients with advanced disease. Despite the overall survival improvement, only a minority of patients benefit from this immunotherapy. Therefore, there is an unmet need to identify prognostic and predictive biomarkers or models to select patients who will benefit from ICIs, especially in view of novel therapeutic agents. This review describes the prognostic and predictive role, and clinical readiness, of clinical and tumour factors, including new molecular classes, tumour mutational burden, mutational signatures, circulating tumour DNA, programmed death-ligand 1, inflammatory indices and clinical characteristics for patients with urothelial cancer treated with ICIs. A classification of these factors according to the levels of evidence and grades of recommendation currently indicates both a prognostic and predictive value for ctDNA and a prognostic relevance only for concomitant medications and patients’ characteristics.

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“…In this context, radiomics—defined as the process of identifying mineable parameters hidden in the pixel of images and routinely non-detectable with the human eye—could potentially have a rising role. Radiomics is being applied in several fields of medicine, with the aim of defining tumor phenotypes, including grade, TME, gene expression, response to systemic treatment, and prediction of clinical outcomes, as demonstrated by numerous studies involving different malignancies [ 13 , 14 , 15 ]. Radiomic features present several advantages for clinical oncology application in the near future.…”

Section: Introductionmentioning

confidence: 99%

The Role of Radiomics in the Era of Immune Checkpoint Inhibitors: A New Protagonist in the Jungle of Response Criteria

Castello

Castellani

Florimonte

et al. 2022

JCM

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Immune checkpoint inhibitors (ICI) have demonstrated encouraging results in terms of durable clinical benefit and survival in several malignancies. Nevertheless, the search to identify an “ideal” biomarker for predicting response to ICI is still far from over. Radiomics is a new translational field of study aiming to extract, by dedicated software, several features from a given medical image, ranging from intensity distribution and spatial heterogeneity to higher-order statistical parameters. Based on these premises, our review aims to summarize the current status of radiomics as a potential predictor of clinical response following immunotherapy treatment. A comprehensive search of PubMed results was conducted. All studies published in English up to and including December 2021 were selected, comprising those that explored computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) for radiomic analyses in the setting of ICI. Several studies have demonstrated the potential applicability of radiomic features in the monitoring of the therapeutic response beyond the traditional morphologic and metabolic criteria, as well as in the prediction of survival or non-invasive assessment of the tumor microenvironment. Nevertheless, important limitations emerge from our review in terms of standardization in feature selection, data sharing, and methods, as well as in external validation. Additionally, there is still need for prospective clinical trials to confirm the potential significant role of radiomics during immunotherapy.

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Systematic review of radiomic biomarkers for predicting immune checkpoint inhibitor treatment outcomes

Cited by 19 publications

References 45 publications

Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

Prognostic and Predictive Factors in Advanced Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors: A Review of the Current Evidence

The Role of Radiomics in the Era of Immune Checkpoint Inhibitors: A New Protagonist in the Jungle of Response Criteria

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