Development of a radiomic-clinical nomogram for prediction of survival in patients with diffuse large B-cell lymphoma treated with chimeric antigen receptor T cells

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

BACKGROUND: In our current work, an 18F-FDG PET/CT radiomics-based model was developed to assess the progression-free survival (PFS) and overall survival (OS) of patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who received chimeric antigen receptor (CAR)-T cell therapy.

METHODS: A total of 61 DLBCL cases receiving 18F-FDG PET/CT before CAR-T cell infusion were included in the current analysis, and these patients were randomly assigned to a training cohort (n = 42) and a validation cohort (n = 19). Radiomic features from PET and CT images were obtained using LIFEx software, and radiomics signatures (R-signatures) were then constructed by choosing the optimal parameters according to their PFS and OS. Subsequently, the radiomics model and clinical model were constructed and validated.

RESULTS: The radiomics model that integrated R-signatures and clinical risk factors showed superior prognostic performance compared with the clinical models in terms of both PFS (C-index: 0.710 vs. 0.716; AUC: 0.776 vs. 0.712) and OS (C-index: 0.780 vs. 0.762; AUC: 0.828 vs. 0.728). For validation, the C-index of the two approaches was 0.640 vs. 0.619 and 0.676 vs. 0.699 for predicting PFS and OS, respectively. Moreover, the AUC was 0.886 vs. 0.635 and 0.778 vs. 0.705, respectively. The calibration curves indicated good agreement, and the decision curve analysis suggested that the net benefit of radiomics models was higher than that of clinical models.

CONCLUSIONS: PET/CT-derived R-signature could be a potential prognostic biomarker for R/R DLBCL patients undergoing CAR-T cell therapy. Moreover, the risk stratification could be further enhanced when the PET/CT-derived R-signature was combined with clinical factors.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:149

Enthalten in:

Journal of cancer research and clinical oncology - 149(2023), 13 vom: 03. Okt., Seite 11549-11560

Sprache:

Englisch

Beteiligte Personen:

Zhou, Yeye [VerfasserIn]
Zhang, Bin [VerfasserIn]
Han, Jiangqin [VerfasserIn]
Dai, Na [VerfasserIn]
Jia, Tongtong [VerfasserIn]
Huang, Haiwen [VerfasserIn]
Deng, Shengming [VerfasserIn]
Sang, Shibiao [VerfasserIn]

Links:

Volltext

Themen:

0Z5B2CJX4D
CAR-T
Diffuse large B-cell lymphoma
Fluorodeoxyglucose F18
Journal Article
PET/CT
Prognosis
Radiomics
Randomized Controlled Trial
Receptors, Chimeric Antigen

Anmerkungen:

Date Completed 31.08.2023

Date Revised 31.08.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00432-023-05038-w

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358970520