As the most common cancer type across the globe, lung cancer is now the leading cause of cancer death worldwide [1]. Cancer immunotherapy using immune checkpoint inhibitors is a promising new strategy for the treatment of advanced cancers. Immune checkpoint inhibitors targeting programmed cell death-1 (PD-1) or program death ligand 1 (PD-L1) have become an important innovative treatment [2-3] for metastatic lung cancer resulting in increased overall survival compared with standard chemotherapy [4-5]. Owing a novel mechanism of action, immune checkpoint inhibitors can generate a...

Patient population In this preliminary study twelve patients with pathologically confirmed non-small cell lung (NSCL) carcinoma with stage IV disease, were prospectively enrolled. All the selected population underwent to immunotherapy treatment as first line (Pembrolizumab) between March 2016 and December 2018. All the patients underwent a Multi-Detector CT (MDCT) investigation prior the beginning of therapy (baseline CT) and after 8-12 weeks from the beginning of it (Follow-up CT). In case of iUPD an additional CT examination was performed after 4-8 weeks to confirm the progression...

Final study population consisted of six patients (three males and three females, mean age 68.8 ± 15.4); the other six patients were excluded for drug toxicity (n= 2), lung surgery prior the beginning of immunotherapy (n= 3) and impossibility to underwent enhanced MDCT due renal impairment (n= 1). For each included patients the chosen target lesions were analyzed at baseline and at follow-up. According to the iRECIST criteria, three patients (50%) were classified as iCPD (Fig.1) while three patients (50%) showed iPR (Fig.2). At the...

iPR was associated with a significant decrease of tumor’s mean grey level intensity, and kurtosis and an increase of skewness while patients with iCPD showed an opposite trend of the same texture parameters. In conclusion, CT texture analysis may play a relevant role in predicting response to immunotherapy in NSCL cancer in accordance with iRECIST.

E. Rosati, MD University of Rome “Sapienza” Radiology Unit - Sant’Andrea University Hospital Phone: +393382614096 e-mail: [email protected]

1. Siegel RL, Miller KD, Jemal A. (2016) Cancer statistics. CA Cancer J Clin 66:7-30 2. Holt GE, Podack ER, Raez LE. (2011) Immunotherapy as a strategy for the tretment of non-small cell lung cancer. Therapy 8:43-54 3. Topalian SL, Hodi FS, Brahmer JR, Gettinger SN, Smith DC, McDermott DF, et al. (2012) Safety, activity, and immune correlates of anti-pd1 antibody in cancer. N Eng J Med 366:2443-54 4. Rizvi NA, Mazières J, Planchard D, Stinchcombe TE, Dy GK, Antonia SJ, et al. (2015) Activity...