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M.V. Bluthgen
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-042 - Evaluation of Texture Analysis Parameters in EGFR Mutated or ALK-Positive Advanced Non-Small Cell Lung Cancer (NSCLC) (ID 1394)
09:30 - 09:30 | Author(s): M.V. Bluthgen
- Abstract
Background:
The quantitative assessment of heterogeneity in tumor images through Texture Analysis is an emerging tool that can potentially provide a non-invasive prognostic biomarker. We investigated if Texture Analysis parameters derived from contrast-enhanced CT (CTTA) were associated with EGFR/ALK status and have a prognostic value in NSCLC patients treated with tyrosine-kinase inhibitors.
Methods:
The CT images of patients with EGFR mutated or ALK rearranged advanced NSCLC treated with tyrosine-kinase inhibitors were retrospectively reviewed. CTTA using the filtration-histogram method was applied to the region of interest (ROI) in the primary tumor of the enhanced-CT by two independent operators to examine the inter-individual reproducibility. A wilcoxon test was used to correlate CTTA with EGFR / ALK status and a Cox model to evaluate the prognostic value of CTTA for overall survival. A p-value cutoff of 0.01 was used to adjust for multiple testing.
Results:
CTTA parameters were evaluated in CT scan from 68 patients recruited in 2 centers between 2008 and 2013, of them, 80.9% (n=55) were EGFR mutated and 19.1 % (n=13) ALK+ NSCLC, 48.5% received treatment with gefitinib (n=33), 33.8% with erlotinib (n=23) and 17.7% with crizotinib (n=12). The CTTA measures were highly reproducible between the 2 operators as indicated by Bland-Altman plots and correlation values. The skewness of the distribution was significantly different between EGFR mutated and ALK+ tumors for coarse texture with spatial filter value 3.3 (p= 0.002), filter value 2.8 (p=0.001) and medium texture with spatial filter value 2.2 (p=0.004). The median follow-up time was 35 months; 39 deaths occurred. The A unit increase in skewness in coarse texture (2.8 spatial filter) was significantly associated with better survival with an univariate cox analysis (HR: 0.36 [0.2-0.69] p=0.002). A multivariate analysis adjusted by prognostic factors (PS, lymphocyte count, hepatic and adrenal metastasis) indicate a similar trend for better survival (HR: 0.40 [0.2-0.8] p=0.01).
Conclusion:
CTTA parameters were reproducible between the 2 operators. The skewness was significantly different between EGFR mutated and ALK rearranged advanced NSCLC and may have a prognostic value.
