1. Novel radiogenomics approach to predict and characterize pneumonitis in stage III NSCLC.
- Author
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Delasos, Lukas, Khorrami, Mohammadhadi, Viswanathan, Vidya S., Jazieh, Khalid, Ding, Yifu, Mutha, Pushkar, Stephans, Kevin, Gupta, Amit, Pennell, Nathan A., Patil, Pradnya D., Higgins, Kristin, and Madabhushi, Anant
- Subjects
RADIATION pneumonitis ,IMMUNE checkpoint inhibitors ,PNEUMONIA ,MITOGEN-activated protein kinases ,T cells - Abstract
Unresectable stage III NSCLC is now treated with chemoradiation (CRT) followed by immune checkpoint inhibitors (ICI). Pneumonitis, a common CRT complication, has heightened risk with ICI, potentially causing severe outcomes. Currently, there are no biomarkers to predict pneumonitis risk or differentiate between radiation-induced pneumonitis (RTP) and ICI-induced pneumonitis (IIP). This study analyzed 293 patients from two institutions, with 140 experiencing pneumonitis (RTP: 84, IIP: 56). Two models were developed: M1 predicted pneumonitis risk using seven radiomic features, achieving high accuracy across internal and external datasets (AUCs: 0.76 and 0.85). M2 differentiated RTP from IIP, with strong performance (AUCs: 0.86 and 0.81). Gene set enrichment analysis linked high pneumonitis risk to pathways such as ECM-receptor interaction and T-cell signaling, while high IIP risk correlated with MAPK and JAK–STAT pathways. Radiomic models show promise in early pneumonitis risk stratification and distinguishing pneumonitis types, potentially guiding personalized NSCLC treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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