Noninvasive imaging of the tumor immune microenvironment correlates with response to immunotherapy in gastric cancer

• Published in: Nature communications Vol. 13; no. 1; pp. 5095 - 14
• Main Authors: Huang, Weicai, Jiang, Yuming, Xiong, Wenjun, Sun, Zepang, Chen, Chuanli, Yuan, Qingyu, Zhou, Kangneng, Han, Zhen, Feng, Hao, Chen, Hao, Liang, Xiaokun, Yu, Shitong, Hu, Yanfeng, Yu, Jiang, Chen, Yan, Zhao, Liying, Liu, Hao, Zhou, Zhiwei, Wang, Wei, Xu, Yikai, Li, Guoxin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 30.08.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 13/51; 631/250/251/1574; 631/67/1504/1829; 631/67/1857; 631/67/2321; 631/67/327; Biomarkers; Cancer; Computed tomography; Correlation; Gastric cancer; Humanities and Social Sciences; Humans; Immunotherapy; Leukocytes (neutrophilic); Lymphocytes; Lymphocytes - pathology; Medical imaging; Microenvironments; multidisciplinary; Neutrophils - pathology; PD-1 protein; Prognosis; Radiomics; Science; Science (multidisciplinary); Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - pathology; Stomach Neoplasms - therapy; Tumor Microenvironment; Tumors
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-022-32816-w

The tumor immune microenvironment (TIME) is associated with tumor prognosis and immunotherapy response. Here we develop and validate a CT-based radiomics score (RS) using 2272 gastric cancer (GC) patients to investigate the relationship between the radiomics imaging biomarker and the neutrophil-to-lymphocyte ratio (NLR) in the TIME, including its correlation with prognosis and immunotherapy response in advanced GC. The RS achieves an AUC of 0.795–0.861 in predicting the NLR in the TIME. Notably, the radiomics imaging biomarker is indistinguishable from the IHC-derived NLR status in predicting DFS and OS in each cohort (HR range: 1.694–3.394, P  < 0.001). We find the objective responses of a cohort of anti-PD-1 immunotherapy patients is significantly higher in the low-RS group (60.9% and 42.9%) than in the high-RS group (8.1% and 14.3%). The radiomics imaging biomarker is a noninvasive method to evaluate TIME, and may correlate with prognosis and anti PD-1 immunotherapy response in GC patients. Tumour microenvironment has been linked with immunotherapy response in gastric cancer. Here, the authors use CT-based radiomics to predict neutrophils-to-lymphocyte ratio and response to immunotherapy.