Research in context
Evidence before this study
We searched PubMed and Google Scholar for papers published before Aug 10, 2018, with the terms (“texture analysis” OR “radiomics” OR “radiomic” OR “computational imaging”) AND (“immunotherapy” OR “immune”), with no language restrictions. To our knowledge, there are no published studies that evaluate the use of radiomics to predict response to immunotherapy. Four studies have evaluated the associations between radiomics and immune infiltration or molecular pathways involved in the immune response; however, the level of evidence of these studies is still low: only one study has an external validation cohort.
Added value of this study
To our knowledge, our study is the first to develop and validate a radiomics-based biomarker of tumour-infiltrating CD8 cells to show a correlation of the number of tumour-infiltrating lymphocytes (as estimated by a pathologist), tumour immune phenotypes, and clinical responses to anti-programmed cell death protein-1 or anti-programmed cell death ligand 1 immunotherapy in three independent cohorts of patients with advanced solid tumours.
Implications of all the available evidence
Our study suggests that there is potential for non-invasive biomarker development in immunotherapy.