PO.CL01.04 · 临床研究

QVT Subscore: An interpretable radiomic panel of tumor vascularity reveals treatment-specific mechanisms-of-action (MoA) in NSCLC

编号 3751 展板 23 时间 4/20 02:00–05:00 区域 Section 41 主讲 Haojia Li

分会场 Biomarkers Predictive of Therapeutic Benefit 4

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作者与单位

Haojia Li¹, Pushkar Mutha², Young Kwang Chae³, Kai Zhang¹, Liam Il-Young Chung³, Amogh Hiremath¹, Rhea Chitalia¹, Justin Yau³, Omid Haji-Maghsoudi¹, Trishan Arul¹, Vamsidhar Velcheti⁴, Anant Madabhushi¹, Nathaniel Braman¹

¹Picture Health, Cleveland, OH,²Wallace H. Coulter Department of Biomedical Engineering,Georgia Institute of Technology and Emory University, Atlanta, GA,³Feinberg School of Medicine, Northwestern University, Chicago, IL,⁴Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL

摘要 Abstract

$$table_{774030D8-7D98-4A70-A26A-2AD4F40BA9E4}$$ Table1: Directionality of QVT Score and Subscore change from baseline to first on-treatment CT Treatment Group S0819 arm1: mono chemotherapy (chemo) S0819 arm2: chemo+cetuximab (cet) S0819 arm3: chemo+bevacizumab(bev) S0819 arm4: chemo+cet + bev mono ICI N 170 157 116 114 147 QVT Score — — ⬇︎ ⬇︎ ⬆︎ Subscore 1: Branching — — ⬇︎ ⬇︎ ⬆︎ Subscore 2: Curvature — — ⬇︎ ⬇︎ ⬆︎ Subscore 3: Torsion — — ⬇︎ ⇩ ⬆︎ Subscore 4: Radius — — ⬇︎ — — Subscore 5: Vessel Volume — — — — ⬆︎ Subscore 6: Inflection Points — — ⬇︎ ⇩ ⬆︎ Note: Black Arrow p<=0.05, White Arrow 0.05<p<0.1, — no trend Background: Tumor angiogenesis drives treatment resistance by fostering an immunosuppressive microenvironment. VEGF inhibitors (VEGFi) target the vasculature, while immune checkpoint inhibitors (ICI) do not address this mechanism directly. Quantitative Vessel Tortuosity (QVT) Score is a radiomic biomarker of vascularity previously shown to be associated with ICI response. Here, we introduce QVT Subscore, an interpretable panel that isolates distinct vascular attributes (e.g., branching, curvature, radius), enabling treatment-specific insight into vascularity MoA and vascular normalization. Methods: QVT Subscores are derived by grouping the 910 QVT features comprising QVT Score into six biological categories, summarized by principal component analysis. The panel was evaluated in 557 patients from the phase 3 SWOG S0819 trial and a real-world ICI monotherapy cohort (n=147). QVT score/subscore changes from baseline to first on-treatment CTs were assessed by paired t-test and substratified by objective response (OR). Results:While the mono-chemotherapy showed no vascularity changes, VEGFi regimens reduced QVT Score, with Branch and Curvature Subscores decreasing significantly but Vessel Volume unchanged. In contrast, ICI recipients exhibited significant increases in QVT Score and 5/6 Subscores, showing opposite changes to VEGFi in four subscores and differing effects on vessel Radius and Volume. VEGFi produced the greatest vascularity decrease in patients achieving OR, with milder decreases in non-OR. For ICI, OR showed negligible QVT change, while vascularity significantly increased in non-OR across all subscores except Radius. Conclusions: The QVT Subscore panel captures granular tumor vascular remodeling from different treatments, providing mechanistically grounded insights into clinical trial arm performance. Future work will assess the panel's potential for identifying regimens that benefit from adding VEGFi.

利益披露 Disclosure

H. Li, Picture Health Employment, Stock Option. P. Mutha, None. Y. Chae, Roche/Genentech advisory board. AstraZeneca advisory board. Foundation Medicine advisory board. Counsyl advisory board. Neogenomics advisory board. Guardant Health advisory board. Boehringer Ingelheim advisory board. Biodesix advisory board. Immuneoncia advisory board. Lilly Oncology advisory board. Merck advisory board. Takeda advisory board. Pfizer advisory board. Tempus advisory board. AbbVie ). BMS ). Biodesix ). Lexent Bio ). Freenome ). K. Zhang, Picture Health Employment, Stock, Stock Option, Patent, Other Intellectual Property, Royalties. Sirona Medical Stock. L. Chung, None. A. Hiremath, Picture Health Employment, Stock. R. Chitalia, Picture Health Employment, Stock. Invicro Employment. J. Yau, None. O. Haji-Maghsoudi, Picture Health Employment, Stock. T. Arul, Picture Health Employment, Stock, Leadership. Path Presenter Consulting or Advisory Role. V. Velcheti, Galvanize Therapeutics Honoraria. Amgen Consulting or Advisory Role. AstraZeneca/MedImmune Consulting or Advisory Role. Bristol-Myers Squibb ), Consulting or Advisory Role. GlaxoSmithKline ), Consulting or Advisory Role. Janssen Oncology Consulting or Advisory Role. Merck ), Consulting or Advisory Role. Novocure Consulting or Advisory Role. Picture Health Consulting or Advisory Role. Regeneron Consulting or Advisory Role. Taiho Oncology Consulting or Advisory Role. Takeda Consulting or Advisory Role. Alkermes ). Altor BioScience ). Atreca ). Eisai ). Genentech ). Genoptix ). Heat Biologics ). Leap Therapeutics ; NantWorks ; OncoPlex Diagnostics ; RSIP Vision ; Trovagene ). A. Madabhushi, Picture Health Employment, Stock, Leadership ,IP Licensed. Inspirata Stock, Leadership, Honoraria, IP licensed ,2 different R01 grants. Elucid Bioimaging Stock, IP Licensed. AstraZeneca Honoraria. Aiforia Consulting or Advisory Role. Caris Life Sciences Consulting or Advisory Role. Castle Biosciences Consulting or Advisory Role. Cernostics Consulting or Advisory Role. Merck Consulting or Advisory Role. Roche Consulting or Advisory Role. SimBioSys Consulting or Advisory Role. Boehringer Ingelheim ). Bristol Myers-Squibb ). Philips Healthcare ). Frederick National Laboratory Advisory Committee member. N. Braman, Picture Health Employment, Stock, Patent, Other Intellectual Property. Tempus Stock, Patent, Other Intellectual Property. IBM Research Patent, Other Intellectual Property.

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