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Gianluca Ficarra

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    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.04-15 - Computerized Tomography Texture Analysis as Biomarker of Benefit from Nivolumab in Advanced Non-Small Cell Lung Cancer (ID 13040)

      16:45 - 18:00  |  Author(s): Gianluca Ficarra

      • Abstract


      While immune checkpoint inhibitors (ICIs) have revolutionized the management of advanced non-small cell lung cancer (NSCLC), response assessment is a challenging task. Indeed, due to the peculiar mechanism of action of ICIs, the currently employed response evaluation criteria based on dimensional assessment might underestimate their activity. Computerized tomography texture analysis (CTTA) is an emerging approach belonging to the field of “radiomics” and based on the analysis of quantitative data extracted from imaging features; recently, correlations between CTTA and histopathologic as well as molecular characteristics of solid tumors were observed. Our aim is to determine whether parameters derived from CTTA might be used to assess the benefit from ICIs in advanced NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Among 74 patients (Pts) treated with nivolumab for advanced NSCLC, 35 had CT scans evaluable for CTTA and had undergone at least two assessments (at baseline and after 4 cycles). Each pulmonary lesion was evaluated by a radiologist experienced in CTTA, blinded to clinical and temporal data; 295 texture analysis parameters were obtained from each image using an open source software (MaZda, version 4.6). The variations of parameters derived from pre-set gray-level co-occurrence matrices (GLCM) before and after 4 cycles of nivolumab were determined and compared with clinical outcomes. Statistical analyses were performed using MedCalc Statistical Software (version 18).

      4c3880bb027f159e801041b1021e88e8 Result

      After a median follow up of 9.9 months, variations of GLCM features describing entropy were directly associated with overall survival (OS). Most notably, Pts with increase of entropy above the median value between baseline and the subsequent CT scan identified with a specific GLCM combination had longer OS (15.3 vs. 6.2 months; p= 0.044). This finding suggests that increased tissue heterogeneity during treatment, possibly caused by immune cells infiltration, might be associated with improved outcomes.

      8eea62084ca7e541d918e823422bd82e Conclusion

      CTTA might have a prognostic/predictive role during treatment with ICIs for NSCLC. Further analyses including clinical and histopathologic features are currently ongoing, in order to enlighten the biological mechanisms at the basis of our observations.