Novel radiogenomics approach to predict and characterize pneumonitis in stage III NSCLC

IF 6.8 1区医学 Q1 ONCOLOGY

NPJ Precision Oncology Pub Date : 2024-12-24 DOI:10.1038/s41698-024-00790-9

Lukas Delasos, Mohammadhadi Khorrami, Vidya S. Viswanathan, Khalid Jazieh, Yifu Ding, Pushkar Mutha, Kevin Stephans, Amit Gupta, Nathan A. Pennell, Pradnya D. Patil, Kristin Higgins, Anant Madabhushi

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引用次数: 0

Abstract

Unresectable stage III NSCLC is now treated with chemoradiation (CRT) followed by immune checkpoint inhibitors (ICI). Pneumonitis, a common CRT complication, has heightened risk with ICI, potentially causing severe outcomes. Currently, there are no biomarkers to predict pneumonitis risk or differentiate between radiation-induced pneumonitis (RTP) and ICI-induced pneumonitis (IIP). This study analyzed 293 patients from two institutions, with 140 experiencing pneumonitis (RTP: 84, IIP: 56). Two models were developed: M1 predicted pneumonitis risk using seven radiomic features, achieving high accuracy across internal and external datasets (AUCs: 0.76 and 0.85). M2 differentiated RTP from IIP, with strong performance (AUCs: 0.86 and 0.81). Gene set enrichment analysis linked high pneumonitis risk to pathways such as ECM-receptor interaction and T-cell signaling, while high IIP risk correlated with MAPK and JAK–STAT pathways. Radiomic models show promise in early pneumonitis risk stratification and distinguishing pneumonitis types, potentially guiding personalized NSCLC treatment.

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新的放射基因组学方法预测和表征III期非小细胞肺癌的肺炎

不可切除的III期NSCLC现在采用放化疗（CRT）和免疫检查点抑制剂（ICI）治疗。肺炎是一种常见的CRT并发症，ICI的风险更高，可能导致严重的后果。目前，还没有生物标志物来预测肺炎风险或区分辐射诱发性肺炎（RTP）和ici诱发性肺炎（IIP）。本研究分析了来自两个机构的293例患者，其中140例患有肺炎（RTP: 84, IIP: 56）。开发了两个模型：M1使用七个放射学特征预测肺炎风险，在内部和外部数据集上实现了很高的准确性（auc: 0.76和0.85）。M2区分RTP和IIP，表现较好（auc分别为0.86和0.81）。基因集富集分析将肺炎高风险与ecm受体相互作用和t细胞信号传导等途径联系起来，而IIP高风险与MAPK和JAK-STAT途径相关。放射组学模型在早期肺炎风险分层和区分肺炎类型方面显示出希望，可能指导个性化的非小细胞肺癌治疗。

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

NPJ Precision Oncology ONCOLOGY-

CiteScore

9.90

自引率

1.30%

发文量

审稿时长

18 weeks

期刊介绍： Online-only and open access, npj Precision Oncology is an international, peer-reviewed journal dedicated to showcasing cutting-edge scientific research in all facets of precision oncology, spanning from fundamental science to translational applications and clinical medicine.