What does radiomics do in PD‐L1 blockade therapy of NSCLC patients?

With the in‐depth understanding of programmed cell death 1 ligand 1 (PD‐L1) in non‐small cell lung cancer (NSCLC), PD‐L1 has become a vital immunotherapy target and a significant biomarker. The clinical utility of detecting PD‐L1 by immunohistochemistry or next‐generation sequencing has been written into guidelines. However, the application of these methods is limited in some circumstances where the biopsy size is small or not accessible, or a dynamic monitor is needed. Radiomics can noninvasively, in real‐time, and quantitatively analyze medical images to reflect deeper information about diseases. Since radiomics was proposed in 2012, it has been widely used in disease diagnosis and differential diagnosis, tumor staging and grading, gene and protein phenotype prediction, treatment plan decision‐making, efficacy evaluation, and prognosis prediction. To explore the feasibility of the clinical application of radiomics in predicting PD‐L1 expression, immunotherapy response, and long‐term prognosis, we comprehensively reviewed and summarized recently published works in NSCLC. In conclusion, radiomics is expected to be a companion to the whole immunotherapy process.