A tumor vasculature–based imaging biomarker for predicting response and survival in patients with lung cancer treated with checkpoint inhibitors
Description
Tumor vasculature is a key component of the tumor microenvironment that can influence tumor behavior and
therapeutic resistance. We present a new imaging biomarker, quantitative vessel tortuosity (QVT), and evaluate
its association with response and survival in patients with non–small cell lung cancer (NSCLC) treated with immune
checkpoint inhibitor (ICI) therapies. A total of 507 cases were used to evaluate different aspects of the QVT
biomarkers. QVT features were extracted from computed tomography imaging of patients before and after ICI
therapy to capture the tortuosity, curvature, density, and branching statistics of the nodule vasculature. Our
results showed that QVT features were prognostic of OS (HR = 3.14, 0.95% CI = 1.2 to 9.68, P = 0.0006, C-index = 0.61)
and could predict ICI response with AUCs of 0.66, 0.61, and 0.67 on three validation sets. Our study shows that
QVT imaging biomarker could potentially aid in predicting and monitoring response to ICI in patients with NSCLC.
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