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. 2023 Sep 7;11(9):2482.
doi: 10.3390/biomedicines11092482.

Change in Splenic Volume as a Surrogate Marker for Immunotherapy Response in Patients with Advanced Urothelial and Renal Cell Carcinoma-Evaluation of a Novel Approach of Fully Automated Artificial Intelligence Based Splenic Segmentation

Gregor Duwe  1 , Lukas Müller  2 , Christian Ruckes  3 , Nikita Dhruva Fischer  1 , Lisa Johanna Frey  1 , Jan Hendrik Börner  1 , Niklas Rölz  1 , Maximilian Haack  1 , Peter Sparwasser  1 , Tobias Jorg  2 , Christopher C M Neumann  4 , Igor Tsaur  1 , Thomas Höfner  1   5 , Axel Haferkamp  1 , Felix Hahn  2 , Rene Mager  1 , Maximilian Peter Brandt  1
Affiliations

Change in Splenic Volume as a Surrogate Marker for Immunotherapy Response in Patients with Advanced Urothelial and Renal Cell Carcinoma-Evaluation of a Novel Approach of Fully Automated Artificial Intelligence Based Splenic Segmentation

Gregor Duwe et al. Biomedicines. .

Abstract

Background: In the treatment of advanced urothelial (aUC) and renal cell carcinoma (aRCC), biomarkers such as PD-1 and PD-L1 are not robust prognostic markers for immunotherapy (IO) response. Previously, a significant association between IO and a change in splenic volume (SV) was described for several tumour entities. To the best of our knowledge, this study presents the first correlation of SV to IO in aUC and aRCC.

Methods: All patients with aUC (05/2017-10/2021) and aRCC (01/2012-05/2022) treated with IO at our academic centre were included. SV was measured at baseline, 3 and 9 months after initiation of IO using an in-house developed convolutional neural network-based spleen segmentation method. Uni- and multivariate Cox regression models for overall survival (OS) and progression-free survival (PFS) were used.

Results: In total, 35 patients with aUC and 30 patients with aRCC were included in the analysis. Lower SV at the three-month follow-up was significantly associated with improved OS in the aRCC group.

Conclusions: We describe a new, innovative artificial intelligence-based approach of a radiological surrogate marker for IO response in aUC and aRCC which presents a promising new predictive imaging marker. The data presented implicate improved OS with lower follow-up SV in patients with aRCC.

Keywords: advanced renal cell carcinoma; advanced urothelial carcinoma; artificial intelligence; immune checkpoint inhibitor; immunotherapy; predictive marker; prognostic marker; splenic volume.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the patient selection process of this study.
Figure 2
Figure 2
Kaplan–Meier curve for patients (aUC and aRCC) with initial low and high splenic volume. Blue line representing patients with initial low splenic volume, green line representing patients with initial high splenic volume.
Figure 3
Figure 3
Kaplan–Meier curve for patients (aUC and aRCC) with decrease and increase in splenic volume three months after start of IO. Blue line representing patients with decrease in splenic volume, green line representing patients with increase in splenic volume.
See this image and copyright information in PMC

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