Tumor mutational burden as a marker for radiologic response to immune checkpoint inhibitors

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology Pub Date : 2024-12-10 DOI:10.1067/j.cpradiol.2024.12.010

Dheeman Futela , Sree Harsha Tirumani , Ezgi Guler , Brandon Declouette , Christopher Hoimes , Nikhil H. Ramaiya

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引用次数: 0

Abstract

Purpose

This study aimed to evaluate the utility of tumor mutational burden (TMB) as a marker for radiologic response to immune checkpoint inhibitor (ICI) therapy at a single tertiary cancer center.

Materials and methods

In this retrospective study, out of 1044 patients treated with ICIs between January 2010 and November 2018, 75 patients (38 males and 37 females) with a mean age of 62 (range 22-87) years, who had information about TMB and adequate imaging, were included. Imaging response was determined according to iRECIST criteria. Predictors of objective response were analysed using non-parametric tests, and progression-free survival and overall survival were analysed using log-rank test.

Results

Median TMB was 7.2 mutations/mb [interquartile range: 4-13.5]. The objective radiologic response rate according to iRECIST was 26.7 % (20 patients) and the median time to best response was 61 days [IQR: 47-88 days]. Median TMB in responders (12.5 [IQR: 5-18] muts/mb) was significantly higher than in non-responders (6 [IQR: 3-12] muts/mb) (p = 0.0293). Median TMB was higher in responders in the subgroup of patients treated with Nivolumab (20 vs 4 muts/mb, P = .0043), but not significantly in those treated with Pembrolizumab (9 vs 6 muts/mb, P = .211). There was no difference in PFS (p = 0.37, Log-Rank) or OS (p = 0.053, Log-Rank) between TMB low and high groups.

Conclusion

Higher TMB was associated with objective response to ICI, however, TMB was an imperfect biomarker for PFS and OS in our study.

查看原文本刊更多论文

将肿瘤突变负荷作为免疫检查点抑制剂放射反应的标志物。

目的：本研究旨在评估肿瘤突变负荷（TMB）作为一个单一三级癌症中心对免疫检查点抑制剂（ICI）治疗的放射学反应标志物的效用：在这项回顾性研究中，纳入了2010年1月至2018年11月期间接受ICIs治疗的1044名患者，其中75名患者（38名男性和37名女性）有TMB信息和充分的影像学资料，平均年龄62岁（22-87岁）。根据 iRECIST 标准确定影像学反应。采用非参数检验分析客观反应的预测因素，采用对数秩检验分析无进展生存期和总生存期：TMB中位数为7.2个突变/mb[四分位数间距：4-13.5]。根据iRECIST标准，客观放射学反应率为26.7%（20例患者），最佳反应时间中位数为61天[IQR：47-88天]。有反应者的中位 TMB（12.5 [IQR: 5-18] muts/mb）明显高于无反应者（6 [IQR: 3-12] muts/mb）（p = 0.0293）。在接受 Nivolumab 治疗的患者亚组中，应答者的中位 TMB 较高（20 vs 4 muts/mb，P = .0043），但在接受 Pembrolizumab 治疗的患者亚组中，应答者的中位 TMB 并不明显（9 vs 6 muts/mb，P = .211）。TMB低组和高组间的PFS（P = 0.37，Log-Rank）或OS（P = 0.053，Log-Rank）没有差异：结论：较高的 TMB 与 ICI 的客观反应相关，但在我们的研究中，TMB 并不是 PFS 和 OS 的完美生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Diagnostic Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.00

自引率

0.00%

发文量

113

审稿时长

46 days

期刊介绍： Current Problems in Diagnostic Radiology covers important and controversial topics in radiology. Each issue presents important viewpoints from leading radiologists. High-quality reproductions of radiographs, CT scans, MR images, and sonograms clearly depict what is being described in each article. Also included are valuable updates relevant to other areas of practice, such as medical-legal issues or archiving systems. With new multi-topic format and image-intensive style, Current Problems in Diagnostic Radiology offers an outstanding, time-saving investigation into current topics most relevant to radiologists.