Radiomic biomarkers for platinum-refractory head and neck cancer in the era of immunotherapy

Area of Science:

• Oncology
• Radiology
• Biomarker Discovery

Background:

• Platinum-refractory head and neck squamous cell carcinoma (HNSCC) has a poor prognosis.
• Immune checkpoint inhibitors (ICI) are a recommended first-line therapy for this condition.
• Effective biomarkers for guiding ICI treatment in HNSCC are limited.

Purpose of the Study:

• To identify radiomic features as prognostic and predictive biomarkers.
• To guide treatment decisions for HNSCC patients receiving ICI therapy.
• To improve patient stratification in the context of ICI treatment.

Main Methods:

• Retrospective analysis of 31 platinum-refractory HNSCC patients.
• Extraction of radiomic features from the primary tumor site at recurrent metastatic (R/M) status.
• Analysis of prognostic and predictive value of radiomic features, including texture analysis and comparison with PD-L1 expression.

Main Results:

• Radiomic features, particularly Grey-level co-occurrence matrix (GLCM) texture features, effectively identified patients at high risk of death within 9 months of R/M status.
• A radiomic risk-stratification model divided patients into high-, intermittent-, and lower-risk groups with significantly different 1-year R/M death rates (100.0% vs. 70.8% vs. 27.1%, p=0.001).
• Short-run high grey-level emphasis (SRHGE) demonstrated superior predictive ability compared to PD-L1 expression for selecting patients for ICI-based therapy.

Conclusions:

• Radiomic features serve as effective prognostic and predictive biomarkers in platinum-refractory HNSCC.
• These radiomic biomarkers can aid in guiding prognosis and treatment strategies in the era of ICI.
• Further research is warranted to validate and implement these findings in clinical practice.