CT-Based Radiomic Signature as a Prognostic Factor in Stage IV ALK-Positive Non-small-cell Lung Cancer Treated With TKI Crizotinib: A Proof-of-Concept Study

Objectives: To identify a computed tomography (CT)-based radiomic signature for predicting progression-free survival (PFS) in stage IV anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC) patients treated with tyrosine kinase inhibitor (TKI) crizotinib.Materials and Methods: This retrospective proof-of-concept study included a cohort of 63 stage IV ALK-positive NSCLC patients who had received TKI crizotinib therapy for model construction and validation. Another independent cohort including 105 stage IV EGFR-positive NSCLC patients was also used for external validation in EGFR-TKI treatment. We initially extracted 481 quantitative three-dimensional features derived from manually segmented tumor volumes of interest. Pearson's correlation analysis along with the least absolute shrinkage and selection operator (LASSO) penalized Cox proportional hazards regression was successively performed to select critical radiomic features. A CT-based radiomic signature for PFS prediction was obtained using multivariate Cox regression. The performance evaluation of the radiomic signature was conducted using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) analysis, and Kaplan–Meier survival analysis.Results: A radiomic signature containing three features showed significant prognostic performance for ALK-positive NSCLC patients in both the training cohort (C-index, 0.744; time-dependent AUC, 0.895) and the validation cohort (C...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research

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Conclusions: The 8-week tumor volume decrease of>74% is significantly associated with longer OS in patients with ALK-rearranged NSCLC treated with crizotinib.
Source: Journal of Thoracic Imaging - Category: Radiology Tags: Original Articles Source Type: research
This study was performed to investigate the clinical and radiologic characteristics and risk factors of ALK-IIP in patients with non-small cell lung cancer (NSCLC). A total of 250 NSCLC patients who had been treated with ALK inhibitors were retrospectively enrolled. Chest computed tomography (CT) was classified into 4 CT patterns using the 2013 guideline for idiopathic interstitial pneumonia: cryptogenic organizing pneumonia (COP), hypersensitivity pneumonitis (HP), acute interstitial pneumonia (AIP), and nonspecific interstitial pneumonia. Clinical characteristics including toxicity grading and treatment course were anal...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusions: Highly specific and accurate scans suggest that the implementation of PET 18F-FDG has had a positive effect on the planning process for patients undergoing cancer treatments. Follow-up imaging has shown the value of proper physiological imaging and its use in radiation treatment planning. Mckay MJ, Taubman KL, Foroudi F, Lee ST, Scott AM. Molecular Imaging Using PET/CT for Radiation Therapy Planning for Adult Cancers: Current Status and Expanding Applications. International Journal of Radiation Oncology, Biology, Physics. 2018;102(4):783-791. Andersson C, Roing M, Tiblom Ehrsson Y, Johansson B. It’s a qu...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Technologist Student Papers II Source Type: research
CONCLUSION: This case describes a relatively young patient with a poor prognosis but with a remarkable and long-term response to crizotinib monotherapy. PMID: 31023173 [PubMed - as supplied by publisher]
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
Mark E. Gray1,2*, James Meehan2,3, Paul Sullivan4, Jamie R. K. Marland4, Stephen N. Greenhalgh1, Rachael Gregson1, Richard Eddie Clutton1, Carol Ward2, Chris Cousens5, David J. Griffiths5, Alan Murray4 and David Argyle1 1The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom 2Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom 3School of Engineering and Physical Sciences, Institute of Sensors, Signals and Systems, Heriot-Watt Univer...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
This study had a retrospective multicenter (two hospitals in China) design and a radiomic analysis was performed using contrast enhanced CT in advanced HGSOC (FIGO stage III or IV) patients. We used a minimum 18-month follow-up period for all patients (median 38.8 months, range 18.8–81.8 months). All patients were divided into three cohorts according to the timing of their surgery and hospital stay: training cohort (TC) and internal validation cohort (IVC) were from one hospital, and independent external validation cohort (IEVC) was from another hospital. A total of 620 3-D radiomic features were extracted and a Lass...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Authors: Tereso A, Carreto L, Baptista M, Almeida MA Abstract The treatment of advanced non-small-cell lung cancer shifted with the development of molecular-targeted therapies, like the tyrosine kinase inhibitors. One example of tyrosine kinase inhibitors is crizotinib, an anaplastic lymphoma tyrosine kinase inhibitor, which targets an echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase gene fusion. This mutation is found in only 2% to 7% of non-small-cell lung cancer cases. Although these new therapies have shown promising results, the occurrence of interstitial lung dis...
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
Rationale: For metastatic non-small cell lung cancer with no epidermal growth factor receptor mutations or anaplastic lymphoma kinase gene rearrangements, programmed cell death-1 (PD-1) blockade is preferentially recommended post first-line chemotherapy. However, still many patients do not respond to these agents. After development of resistance to PD-1 blockade, further evaluation of chemotherapy regimen will be necessary. Patient concerns: A 57-year old man had cough with minimal whitish expectoration. Computed tomography (CT) scans showed that he had an upper lobe mass of his left lung and multiple lymphadenectasis...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract Accurate tumor delineation is a priority in radiation therapy (RT). Metabolic imaging has a key and evolving role in target volume selection and delineation. This is especially so for non-small cell lung cancer, squamous cell cancer of the head and neck, and lymphoma, for which positron emission tomography/computed tomography (PET/CT) is complimentary to structural imaging modalities, not only in delineating primary tumors, but also often in revealing previously undiagnosed regional nodal disease. At some sites, PET/CT has been confirmed to enable target size reduction compared with structural imaging alo...
Source: Health Physics - Category: Physics Authors: Tags: Int J Radiat Oncol Biol Phys Source Type: research
Accurate tumor delineation is a priority in radiation therapy (RT). Metabolic imaging has a key and evolving role in target volume selection and delineation. This is especially so for non-small cell lung cancer, squamous cell cancer of the head and neck, and lymphoma, for which positron emission tomography/computed tomography (PET/CT) is complimentary to structural imaging modalities, not only in delineating primary tumors, but also often in revealing previously undiagnosed regional nodal disease.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Novel Imaging for Treatment Planning Source Type: research
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