Can radiomics personalise immunotherapy?
Menée en France à partir de données portant sur quatre cohortes indépendantes incluant au total 491 patients atteints d'une tumeur solide de stade avancé traitée par anti-PD-1 ou anti-PD-L1, cette étude évalue la performance d'une signature, combinant des données de tomographies numériques avec rehaussement de contraste et des données génomiques obtenues après séquençage de l'ARN d'échantillons tumoraux, pour estimer le niveau d'infiltration des tumeurs par les lymphocytes T CD8+ et prédire la réponse tumorale aux traitements
Immunotherapy by immune checkpoint blockade has emerged as a promising therapeutic option for patients with aggressive tumours. However, the inability to precisely identify the patients who will benefit from these treatments has limited the applicability of immune checkpoint blockade and could put patients at higher risk of immune-related toxicity. Expression of programmed cell death ligand-1 (PD-L1) is a commonly used biomarker that indicates to physicians whether a patient should or should not receive immune checkpoint blockade therapy; this method has been inconsistent and unreliable because of its variability and spatial intratumoral heterogeneity.
A phase 3 trial that compared immune checkpoint blockade and chemotherapy showed no difference between these treatments in the overall survival of patients with increased PD-L1 expression in solid tumours of 5% or more. Therefore, new biomarkers that could integrate several approaches are sought, to stratify patients to receive the most appropriate immunotherapy approaches and for early prediction of patient response to immune checkpoint blockade.
The Lancet Oncology , commentaire, 2017