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Supplementary Figure S7 from Better than RECIST and Faster than iRECIST: Defining the Immunotherapy Progression Decision Score to Better Manage Progressive Tumors on Immunotherapy

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posted on 2023-04-14, 08:22 authored by Younes Belkouchi, Hugues Talbot, Nathalie Lassau, Littisha Lawrance, Siham Farhane, Rahma Feki-Mkaouar, Joya Hadchiti, Lama Dawi, Julien Vibert, Paul-Henry Cournède, Clara Cousteix, Camille Mazza, Michele Kind, Antoine Italiano, Aurelien Marabelle, Samy Ammari, Stephane Champiat

InterpretML Overall Importance using Explainable Boosting Machines (EBM). The mean absolute score reflects the overall importance assigned by the model to predict each patient's category. All features appear important, with the number of organs affected by metastasis and the emergence of new lesions as the most important ones

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Université Paris-Saclay (University of Paris-Saclay)

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ARTICLE ABSTRACT

The objective of the study is to propose the immunotherapy progression decision (iPD) score, a practical tool based on patient features that are available at the first evaluation of immunotherapy treatment, to help oncologists decide whether to continue the treatment or switch rapidly to another therapeutic line when facing a progressive disease patient at the first evaluation. This retrospective study included 107 patients with progressive disease at first evaluation according to RECIST 1.1. Clinical, radiological, and biological data at baseline and first evaluation were analyzed. An external validation set consisting of 31 patients with similar baseline characteristics was used for the validation of the score. Variables were analyzed in a univariate study. The iPD score was constructed using only independent variables, each considered as a worsening factor for the survival of patients. The patients were stratified in three groups: good prognosis (GP), poor prognosis (PP), and critical prognosis (CP). Each group showed significantly different survivals (GP: 11.4, PP: 4.4, CP: 2.3 months median overall survival, P < 0.001, log-rank test). Moreover, the iPD score was able to detect the pseudoprogressors better than other scores. On the validation set, CP patients had significantly worse survival than PP and GP patients (P < 0.05, log-rank test). The iPD score provides oncologists with a new evaluation, computable at first progression, to decide whether treatment should be continued (for the GP group), or immediately changed for the PP and CP groups. Further validation on larger cohorts is needed to prove its efficacy in clinical practice.

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