NCT05711914

Predicting Response to PD-1 Checkpoint Blockade Using Deep Learning Analysis of Imaging and Clinical Data

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 300 (actual)
• Sponsor: Centre Hospitalier Universitaire de Nīmes · Academic / Other
• Sex: All
• Age: 18 Years – 100 Years
• Healthy volunteers: Not accepted

Summary

Immunotherapy has transformed cancer treatment with the PD-1 class of checkpoint inhibitors - pembrolizumab and nivolumab -- demonstrating durable responses in Stage IV metastatic tumors such as non-small cell lung cancer and melanoma. Despite these numerous successes, PD-1/PD-L1 checkpoint blockade therapies do have a number of shortcomings. Many approaches to predict response to PD-1/PD-L1 checkpoint therapy have been investigated with limited success. Recent efforts exploring the utility of quantitative imaging biomarkers to predict response to PD-\[L\]1 immunotherapy have shown promise. The purpose of this retrospective multicenter study is to develop a multi-omic classifier to predict response to PD-1/PD-L1 checkpoint blockade for mutation negative (EGFR, ALK and ROS1) NSCLC

Detailed description

Recent Phase III studies have demonstrated the effectiveness of atezolizumab (PD-L1) in metastatic triple-negative breast cancer \[3\] and small cell lung cancer, while the standard of care for Stage III non-small cell lung cancer has changed with positive results of the PACIFIC Phase III study, where durvalumab (PD-L1) administered after chemoradiation showed a significant increase in overall survival. Low response rates, generally in the 15% to 20% range in most diseases when used as a single agent, high therapy cost globally ($150,000 or more per year in the U.S) and serious immune-mediated adverse events, particularly when PD-1/PD-L1 inhibitors are combined with the CTLA-4 inhibitors (ipilimumab). Unpredictable and low patient response rates coupled with high drugs costs and serious toxicities can significantly burden healthcare systems, third-party payers and patients. Clearly, diagnostic tools to stratify patients according to response likelihood are necessary as PD-\[L\]1 checkpoint inhibitors continue to gain adoption. The standard-of-care biomarker is an immunohistochemistry (IHC) test that measures levels of the PD-L1 protein expressed in tumor samples. Tumor mutational burden, presence of Tumor-Infiltrating Lymphocytes and inflammatory cytokines are being explored in multiple clinical trials involving PD-(L)1 often in combination with additional immuno-oncology (IO) therapies In such an approach, a non-invasive imaging scan can provide insight and information on the patient's entire tumor burden rather than a sample of a subset of lesions (as provided by biopsy or serum-based assays). When diagnostic images that depict all treatable lesions are further analyzed with computational techniques such as machine-learning and artificial intelligence, resulting in the identification of relevant imaging biomarkers, an accurate overall assessment of patient response to PD-\[L\]1 therapy may be attainable.

Conditions

• Non-small Cell Lung Cancer (NSCLC)

Timeline

• Start date: 2021-01-31
• Primary completion: 2022-03-31
• Completion: 2022-12-31
• First posted: 2023-02-03
• Last updated: 2023-02-03

Locations

1 site across 1 country: France