Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2172926. doi: 10.1080/21645515.2023.2172926. Epub 2023 Feb 1.
Immunotherapy has become a cornerstone for the treatment of renal cell carcinoma. Nevertheless, some patients are resistant to immune checkpoint inhibitors. The possibility to identify patients who cannot benefit from immunotherapy is a relevant clinical challenge. We analyzed the association between several radiomics features and response to immunotherapy in 53 patients treated with checkpoint inhibitors for advanced renal cell carcinoma. We found that the following features are associated with progression of disease as best tumor response: F_stat.range ( < .0004), F_stat.max ( < .0007), F_stat.var ( < .0016), F_stat.uniformity ( < .0020), F_stat.90thpercentile ( < .0050). Gross tumor volumes characterized by high values of F_stat.var and F_stat.max (greater than 60,000 and greater than 300, respectively) are most likely related to a high risk of progression. Further analyses are warranted to confirm these results. Radiomics, together with other potential predictive factors, such as gut microbiota, genetic features or circulating immune molecules, could allow a personalized treatment for patients with advanced renal cell carcinoma.
免疫疗法已成为治疗肾细胞癌的基石。然而，一些患者对免疫检查点抑制剂有耐药性。能够识别不能从免疫疗法中获益的患者是一个相关的临床挑战。我们分析了 53 例接受检查点抑制剂治疗的晚期肾细胞癌患者的几种放射组学特征与免疫治疗反应之间的关系。我们发现，以下特征与疾病进展的最佳肿瘤反应相关：F_stat.range（<0.0004），F_stat.max（<0.0007），F_stat.var（<0.0016），F_stat.uniformity（<0.0020），F_stat.90thpercentile（<0.0050）。F_stat.var 和 F_stat.max 值较高（分别大于 60,000 和大于 300）的肿瘤体积特征与进展风险较高最相关。需要进一步的分析来证实这些结果。放射组学与其他潜在的预测因素（如肠道微生物群、遗传特征或循环免疫分子）相结合，可为晚期肾细胞癌患者提供个体化治疗。
