AUTHOR=Gkika Eleni , Benndorf Matthias , Oerther Benedict , Mohammad Farid , Beitinger Susanne , Adebahr Sonja , Carles Montserrat , Schimek-Jasch Tanja , Zamboglou Constantinos , Frye Björn C. , Bamberg Fabian , Waller Cornelius F. , Werner Martin , Grosu Anca L. , Nestle Ursula , Kayser Gian 

TITLE=Immunohistochemistry and Radiomic Features for Survival Prediction in Small Cell Lung Cancer

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01161

DOI=10.3389/fonc.2020.01161

ISSN=2234-943X

ABSTRACT=<p><bold>Background:</bold> The aim of the study was to evaluate the role of different immunohistochemical and radiomics features in patients with small cell lung cancer (SCLC).</p><p><bold>Methods:</bold> Consecutive patients with histologically proven SCLC with limited (<italic>n</italic> = 47, 48%) or extensive disease (<italic>n</italic> = 51, 52%) treated with radiotherapy and chemotherapy at our department were included in the analysis. The expression of different immunohistochemical markers from the initial tissue biopsy, such as CD56, CD44, chromogranin A, synaptophysin, TTF-1, GLUT-1, Hif-1 a, PD-1, and PD-L1, and MIB-1/KI-67 as well as LDH und NSE from the initial blood sample were evaluated. H-scores were additionally generated for CD44, Hif-1a, and GLUT-1. A total of 72 computer tomography (CT) radiomics texture features from a homogenous subgroup (<italic>n</italic> = 31) of patients were correlated with the immunohistochemistry, the survival (OS), and the progression-free survival (PFS).</p><p><bold>Results:</bold> The median OS, calculated from diagnosis, was 21 months for patients with limited disease and 13 months for patients with extensive disease. The expression of synaptophysin correlated with a better OS (HR 0.546 95% CI 0.308–0.966, <italic>p</italic> = 0.03). The expression of TTF-1 (HR 0.286, 95% CI: 0.117–0.698, <italic>p</italic> = 0.006) and a lower GLUT-1 H-score (median = 50, HR: 0.511, 95% CI: 0.260–1.003, <italic>p</italic> = 0.05) correlated with a better PFS. Patients without chromogranin A expression had a higher risk for developing cerebral metastases (<italic>p</italic> = 0.02) and patients with PD 1 expression were at risk for developing metastases (<italic>p</italic> = 0.02). Our radiomics analysis did not reveal a single texture feature that correlated highly with OS or PFS. Correlation coefficients ranged between −0.48 and 0.39 for OS and between −0.46 and 0.38 for PFS.</p><p><bold>Conclusions:</bold> The role of synaptophysin should be further evaluated as synaptophysin-negative patients might profit from treatment intensification. We report an, at most, moderate correlation of radiomics features with overall and progression free survival and no correlation with the expression of different immunohistochemical markers.</p>