Radiomics and PD-L1 expression predict immunotherapy benefits in patients with head and neck squamous cell carcinoma

Abstract

Aim: To evaluate the performance of MRI-derived radiomic risk score (RRS) and PD-L1 expression to predict overall survival (OS) and progression-free survival (PFS) of patients with recurrent head and neck squamous cell carcinoma receiving nivolumab therapy. Materials & methods: Three hundred forty radiomic features from pretreatment MRI were used to construct the RRS. The integrated area under the receiver operating characteristic curve (iAUC) was calculated to evaluate the performance of the RRS and PD-L1. Results: The RRS showed iAUCs of 0.69 and 0.57 for OS and PFS, respectively. PD-L1 expression showed iAUCs of 0.61 and 0.62 for OS and PFS, respectively. Conclusion: RRS and PD-L1 potentially predict the OS and PFS of patients with recurrent head and neck squamous cell carcinoma receiving nivolumab therapy.

Summary points

• Immune checkpoint blockade is the mainstay treatment for most cancer patients, and two anti-PD-1 antibodies have been approved for the treatment of recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).

• There is an unmet need to explore and validate predictive biomarkers for immunotherapy to facilitate the selection of subpopulations of patients with R/M HNSCC who are most likely to benefit.

• Radiomics, a quantitative process utilizing imaging data from predetermined regions of interest, has demonstrated its usefulness in characterizing HNSCC and predicting responses to treatments.

• The predictive value of MRI-based radiomic data in patients with HNSCC receiving immunotherapy has yet to be evaluated.

• This study evaluated the predictive value of MRI-derived radiomic risk score (RRS) and PD-L1 expression for the overall survival (OS) and progression-free survival (PFS) of HNSCC patients receiving nivolumab therapy.

• The RRS, PD-L1, and combined PD-L1 and RRS models demonstrated comparable integrated area under the curve values in predicting OS and PFS.

• Tumor characteristics derived from radiomics, such as smaller tumor size, more spherical shape, and intratumoral homogeneity, may be indicative of better survival outcomes after nivolumab treatment.

• In subgroup analysis, PD-L1 expression score has demonstrated the potential for predicting both OS and PFS in R/M HNSCC patients receiving nivolumab therapy.

• RRS and PD-L1 expression may contribute to better risk stratification and better treatment decisions for patients with R/M HNSCC.

Keywords: :

• immunotherapy
• magnetic resonance imaging
• nivolumab
• radiomics
• squamous cell carcinoma of head and neck
• survival analysis

Supplemental material

Supplemental data for this article can be accessed at https://doi.org/10.1080/14796694.2024.2342226

Author contributions

Conceptualization: Y Sim, B Sohn, SM Lim; data curation: HR Kim, MH Hong, J Kim; formal analysis: Y Sim, B Sohn, SM Lim; investigation: Y Sim, B Sohn, SM Lim; methodology: B Sohnn, S Kim, SM Lim; project administration: SM Lim; resources: HR Kim, MH Hong, J Kim, S-K Lee; software: Y Sim, S Kim; supervision: HR Kim, MH Hong, J Kim, S-K Lee; validation: Y Sim, B Sohn, S Kim, SM Lim; visualization: Y Sim, B Sohn; writing – original draft: Y Sim, B Sohn, SM Lim; writing – review and editing: Y Sim, B Sohn, S Kim, HR Kim, MH Hong, J Kim, S-K Lee, SM Lim.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options, and expert testimony.

Writing disclosure

English language editing was provided by Editage (www.editage.com).

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval (Yonsei University Health System, Severance Hospital, IRB no. 4-2021-1449) and have followed the principles outlined in the Declaration of Helsinki for all human investigations. In addition, informed consent has been obtained from all prospective participants and waived for retrospective participants.

Data sharing statement

Qualified investigators may obtain anonymized data for replication of procedures and results, following ethics clearance and approval by all authors.