Multiparameter prediction model of immune checkpoint inhibitors combined with chemotherapy for non-small cell lung cancer based on support vector machine learning

The reliable predictive markers to identify which patients with advanced non-small cell lung cancer tumors (NSCLC) will achieve durable clinical benefit (DCB) for chemo-immunotherapy are needed. In this retrospective study, we collected radiomics and clinical signatures from 94 patients with advanced NSCLC treated with anti-PD-1/PD-L1 combined with chemotherapy from January 1, 2018 to May 31, 2022. Radiomics variables were extracted from pretreatment CT and selected by Spearman correlation coefficients and clinical features by Logistics regression analysis. We performed effective diagnostic algorithms principal components analysis (PCA) and support vector machine (SVM) to develop an early classification model among DCB and non-durable benefit (NDB) groups. A total of 26 radiomics features and 6 clinical features were selected, and then principal component analysis was used to obtain 6 principal components for SVM building. RC-SVM achieved prediction accuracy with AUC of 0.91 (95% CI 0.87–0.94) in the training set, 0.73 (95% CI 0.61–0.85) in the cross-validation set, 0.84 (95% CI 0.80–0.89) in the external validation set. The new method of RC-SVM model based on radiomics-clinical signatures provides a significant additive value on response prediction in patients with NSCLC preceding chemo-immunotherapy.