Deep Learning Model Predicts Pathological Complete Response of Lung Cancer Following Neoadjuvant Immunochemotherapy

Not yet recruiting

• Conditions: Pathological Complete Response; Deep Learning Model; Non-small Cell Lung Cancer; Neoadjuvant Chemoimmunotherapy
• Interventions: Diagnostic Test: No interventions

• Registration Number: NCT06285058
• Lead Sponsor: Wuhan Union Hospital, China

Brief Summary

This study presents the development and validation of an artificial intelligence (AI) prediction system that utilizes pre-neoadjuvant immunotherapy plain scans and enhanced multimodal CT scans to extract deep learning features. The aim is to predict the occurrence of pathological complete response in non-small cell lung cancer patients undergoing neoadjuvant immunochemotherapyy.

Detailed Description

This study retrospectively obtained non-contrast enhanced and contrast enhanced CT scans of patients with NSCLC who underwent surgery after receiving neoadjuvant immunochemotherapy. at multiple centers between August 2019 and February 2023. Deep learning features were extracted from both non-contract enhanced and contract enhanced CT scans to construct the predictive models (LUNAI-nCT model and LUNAI-eCT model), respectively. After feature fusion of these two types of features, a fused model (LUNAI-fCT model) was constructed. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). SHapley Additive exPlanations (SHAP) analysis was used to quantify the impact of CT imaging features on model prediction. To gain insights into how our model makes predictions, we employed Gradient-weighted Class Activation Mapping (Grad-CAM) to generate saliency heatmaps.

Study Timeline

• Status Verified: 2024-02
• Study First Submitted: 2024-02-22
• Study First Submitted QC: 2024-02-22
• Study First Posted: 2024-02-29
• Study Start: 2024-03
• Last Update Submitted: 2024-03-11
• Last Update Posted: 2024-03-13
• Primary Completion: 2025-12
• Study Completion: 2026-03

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 1000

Inclusion Criteria

1. Patients' with non-small cell lung cancer, diagnosed through biopsy pathology and clinically classified as stage IB to III;
2. Patients who receive at least two cycles of neoadjuvant immunotherapy combined with chemotherapy induction therapy;
3. According to the IASLC guidelines, postoperative pathological evaluation was performed on the treatment response of the tumor primary lesion and lymph nodes.

Exclusion Criteria

1. Missing or inadequate quality of CT;
2. Time interval between CT and start of treatment is greater than 1 month;
3. Incomplete clinicopathologic data.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Training dataset	No interventions	patients who were diagnosed with non-small cell carcinoma and undergo surgery after neoadjuvant chemoimmunotherapy treatment at hospital 1 (Tongji Medical College Affiliated Union Hospital)

Primary Outcome Measures

Name	Time	Method
the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of predicting model	Baseline treatment	several metrics were calculated, including accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).