PMID- 30643941 OWN - NLM STAT- MEDLINE DCOM- 20190605 LR - 20210109 IS - 1432-1084 (Electronic) IS - 0938-7994 (Print) IS - 0938-7994 (Linking) VI - 29 IP - 5 DP - 2019 May TI - Development and validation of a prognostic index for efficacy evaluation and prognosis of first-line chemotherapy in stage III-IV lung squamous cell carcinoma. PG - 2388-2398 LID - 10.1007/s00330-018-5912-2 [doi] AB - OBJECTIVES: To establish a pre-therapy prognostic index model (PIM) of the first-line chemotherapy aiming to achieve accurate prediction of time to progression (TTP) and overall survival among the patients diagnosed with locally advanced (stage III) or distant metastasis (stage IV) lung squamous cell carcinoma (LSCC). METHODS: Ninety-six LSCC patients treated with first-line chemotherapy were retrospectively enrolled to build the model. Fourteen epidermal growth factor receptor (EGFR)-mutant LSCC patients treated with first-line EGFR-tyrosine kinase inhibitor (TKI) therapy were enrolled for validation dataset. From CT images, 56,000 phenotype features were initially computed. PIM was constructed by integrating a CT phenotype signature selected by the least absolute shrinkage and selection operator and the significant blood-based biomarkers selected by multivariate Cox regression. PIM was then compared with other four prognostic models constructed by the CT phenotype signature, clinical factors, post-therapy tumor response, and Glasgow Prognostic Score. RESULTS: The signature includes eight optimal features extracted from co-occurrence, run length, and Gabor features. By using PIM, chemotherapy efficacy of patients categorized in the low-risk, intermediate-risk, and high-risk progression subgroups (median TTP = 7.2 months, 3.4 months, and 1.8 months, respectively) was significantly different (p < 0.0001, log-rank test). Chemotherapy efficacy of the low-risk progression subgroup was comparable with EGFR-TKI therapy (p = 0.835, log-rank test). Prognostic prediction of chemotherapy efficacy by PIM was significantly higher than other models (p < 0.05, z test). CONCLUSION: The study demonstrated that the PIM yielded significantly higher performance to identify individual stage III-IV LSCC patients who can potentially benefit most from first-line chemotherapy, and predict the risk of failure from chemotherapy for individual patients. KEY POINTS: * TTP and OS of first-line chemotherapy in individual stage III-IV LSCC patients could be predicted by pre-therapy blood-based biomarkers and image-based signatures. * Risk status of pre-therapy indicators affected the efficacy of first-line chemotherapy in stage III-IV LSCC patients. * Those stage III-IV LSCC patients who were able to achieve similar efficacy to EGFR-TKI therapy through chemotherapy were identified. FAU - Song, Jiangdian AU - Song J AD - School of Medical Informatics, China Medical University, Shenyang, Liaoning, China. AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. FAU - Tian, Jie AU - Tian J AD - CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China. FAU - Zhang, Lina AU - Zhang L AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. FAU - Qu, Xiujuan AU - Qu X AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. FAU - Qian, Wei AU - Qian W AD - College of Engineering, University of Texas, El Paso, TX, USA. AD - Sino-Dutch Biomedical Engineering School, Northeastern University, Shenyang, Liaoning, China. FAU - Zheng, Bin AU - Zheng B AD - Sino-Dutch Biomedical Engineering School, Northeastern University, Shenyang, Liaoning, China. AD - Medicine and Biological Information Engineering, University of Oklahoma, Norman, OK, USA. FAU - Zhang, Lina AU - Zhang L AD - Department of Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Zhao, Jia AU - Zhao J AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. FAU - Niu, Meng AU - Niu M AD - Department interventional therapy, The First Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Zhou, Mu AU - Zhou M AD - Artificial Intelligence in Medicine and Imaging (AIMI) Center, Department of Radiology, Stanford University, San Francisco, CA, USA. FAU - Cui, Lei AU - Cui L AD - School of Medical Informatics, China Medical University, Shenyang, Liaoning, China. FAU - Liu, Yunpeng AU - Liu Y AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. ypliu@cmu.edu.cn. FAU - Zhao, Mingfang AU - Zhao M AD - Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China. mfzhao@cmu.edu.cn. LA - eng GR - 2016YFC1303800/National Key R&D Program of China/ GR - 2018M630310/China Postdoctoral Science Foundation/ PT - Journal Article DEP - 20190114 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Protein Kinase Inhibitors) RN - EC 2.7.10.1 (EGFR protein, human) RN - EC 2.7.10.1 (ErbB Receptors) RN - S65743JHBS (Gefitinib) SB - IM MH - Aged MH - Carcinoma, Non-Small-Cell Lung/pathology MH - Carcinoma, Squamous Cell/diagnosis/*drug therapy MH - ErbB Receptors MH - Female MH - Gefitinib/*therapeutic use MH - Humans MH - Lung Neoplasms/*diagnosis/drug therapy MH - Male MH - Multidetector Computed Tomography/methods MH - *Neoplasm Staging MH - Prognosis MH - Protein Kinase Inhibitors/therapeutic use MH - Reproducibility of Results MH - Retrospective Studies PMC - PMC6443600 OTO - NOTNLM OT - Biomarkers OT - Carcinoma OT - Prognosis OT - Squamous cell OT - Tumor COIS- GUARANTOR: The scientific guarantor of this publication is Prof. Mingfang Zhao. CONFLICT OF INTEREST: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. STATISTICS AND BIOMETRY: Prof. Cui is an expert in the field of medical statistics. We consulted him about the statistics analysis in this study. INFORMED CONSENT: Written informed consent was waived by the Institutional Review Board. ETHICAL APPROVAL: Institutional Review Board approval was obtained. METHODOLOGY: * retrospective * diagnostic or prognostic study * performed at one institution EDAT- 2019/01/16 06:00 MHDA- 2019/06/06 06:00 PMCR- 2019/01/14 CRDT- 2019/01/16 06:00 PHST- 2018/06/02 00:00 [received] PHST- 2018/11/23 00:00 [accepted] PHST- 2018/10/13 00:00 [revised] PHST- 2019/01/16 06:00 [pubmed] PHST- 2019/06/06 06:00 [medline] PHST- 2019/01/16 06:00 [entrez] PHST- 2019/01/14 00:00 [pmc-release] AID - 10.1007/s00330-018-5912-2 [pii] AID - 5912 [pii] AID - 10.1007/s00330-018-5912-2 [doi] PST - ppublish SO - Eur Radiol. 2019 May;29(5):2388-2398. doi: 10.1007/s00330-018-5912-2. Epub 2019 Jan 14.