Felfli Mehdi, Thinnes Alexandre, Jacques Sebastien, Liu Yan, Iannessi Antoine
Median Technologies, Imaging Lab, Valbonne, France.
Centre Antoine Lacassagne, Radiology Department, Nice, France.
Front Immunol. 2024 Dec 20;15:1470555. doi: 10.3389/fimmu.2024.1470555. eCollection 2024.
Assess the contribution of early tumor growth dynamics modeling to predict clinical outcomes in non-small cell lung cancer patients receiving immunotherapy, alongside standard RECIST 1.1 criteria.
Our retrospective studies used data from 861 patients with advanced NSCLC enrolled in three randomized Phase III trials evaluating immunotherapy plus chemotherapy were analyzed. Tumor size measurements up to two follow-up time points were used to fit a novel Gompertz model and estimate growth rate (GR) and kinetic parameters representing depth of response (A), speed of response (B), and long-term modulation (M). Correlations between these early tumor growth parameters and clinical outcomes such as progression-free survival (PFS) and time to response (TTR) were assessed. Descriptive and discriminative analyses were performed to delineate tumor growth dynamics across various response profiles based on RECIST 1.1 criteria.
The novel Gompertz model accurately described early tumor growth kinetics in 861 non-small cell lung cancer patients treated with immunotherapy. Lower growth rate (GR) and model parameter M were associated with longer progression-free survival (PFS) (HR=0.897 and 7.47x10^-7, respectively). Higher GR and parameter A correlated with shorter time to response (HR=0.575 and 0.696, respectively). Responders had significantly lower A (p=1.51e-53) and higher GR (p=0.4e-12) than non-responders. Non-durable stable disease patients had higher GR (p=0.0001) and parameter B (p=0.0002) compared to late responders. Early tumor growth parameters showed potential for predicting long-term outcomes and treatment response patterns.
评估早期肿瘤生长动力学模型在预测接受免疫治疗的非小细胞肺癌患者临床结局方面的作用，同时结合标准的RECIST 1.1标准。
我们的回顾性研究分析了861例晚期非小细胞肺癌患者的数据，这些患者参与了三项评估免疫治疗联合化疗的III期随机试验。利用至多两个随访时间点的肿瘤大小测量数据来拟合一个新的Gompertz模型，并估计生长率（GR）以及代表反应深度（A）、反应速度（B）和长期调节（M）的动力学参数。评估这些早期肿瘤生长参数与无进展生存期（PFS）和反应时间（TTR）等临床结局之间的相关性。基于RECIST 1.1标准进行描述性和判别性分析，以描绘不同反应特征下的肿瘤生长动力学。
新的Gompertz模型准确描述了861例接受免疫治疗的非小细胞肺癌患者的早期肿瘤生长动力学。较低的生长率（GR）和模型参数M与更长的无进展生存期（PFS）相关（风险比分别为0.897和7.47×10^-7）。较高的GR和参数A与更短的反应时间相关（风险比分别为0.575和0.696）。与无反应者相比，反应者的A显著更低（p = 1.51×10^-53），GR显著更高（p = 0.4×10^-12）。与晚期反应者相比，非持久稳定疾病患者的GR更高（p = 0.0001），参数B更高（p = 0.0002）。早期肿瘤生长参数显示出预测长期结局和治疗反应模式的潜力。
