Development and validation of a radiomics-based nomogram for predicting a major pathological response to neoadjuvant immunochemotherapy for patients with potentially resectable non-small cell lung cancer

Front Immunol. 2023 Feb 16:14:1115291. doi: 10.3389/fimmu.2023.1115291. eCollection 2023.

Abstract

Introduction: The treatment response to neoadjuvant immunochemotherapy varies among patients with potentially resectable non-small cell lung cancers (NSCLC) and may have severe immune-related adverse effects. We are currently unable to accurately predict therapeutic response. We aimed to develop a radiomics-based nomogram to predict a major pathological response (MPR) of potentially resectable NSCLC to neoadjuvant immunochemotherapy using pretreatment computed tomography (CT) images and clinical characteristics.

Methods: A total of 89 eligible participants were included and randomly divided into training (N=64) and validation (N=25) sets. Radiomic features were extracted from tumor volumes of interest in pretreatment CT images. Following data dimension reduction, feature selection, and radiomic signature building, a radiomics-clinical combined nomogram was developed using logistic regression analysis.

Results: The radiomics-clinical combined model achieved excellent discriminative performance, with AUCs of 0.84 (95% CI, 0.74-0.93) and 0.81(95% CI, 0.63-0.98) and accuracies of 80% and 80% in the training and validation sets, respectively. Decision curves analysis (DCA) indicated that the radiomics-clinical combined nomogram was clinically valuable.

Discussion: The constructed nomogram was able to predict MPR to neoadjuvant immunochemotherapy with a high degree of accuracy and robustness, suggesting that it is a convenient tool for assisting with the individualized management of patients with potentially resectable NSCLC.

Keywords: NSCLC; major pathological response; neoadjuvant immunochemotherapy; nomogram; radiomics.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Non-Small-Cell Lung*
  • Humans
  • Immunotherapy
  • Lung Neoplasms*
  • Neoadjuvant Therapy
  • Nomograms

Grants and funding

This study was supported by the National Natural Science Foundation of China (82102157), the Hunan Provincial Natural Science Foundation for Excellent Young Scholars (2022JJ20089), the Hunan Provincial Natural Science Foundation of China (2021JJ40895, 2022JJ70053), the Research Project of Postgraduate Education and Teaching Reform of Central South University (2021JGB147, 2022JGB117), the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University, the Clinical Research Center For Medical Imaging In Hunan Province (2020SK4001), and the Science and Technology Innovation Program of Hunan Province (2021RC4016).