What question did this study set out to answer?

To validate the Enhanced CT Response Score (eCTRS) as a predictor of survival in PD-L1–high mNSCLC patients receiving ICI monotherapy.

External validation of a deep learning CT biomarker to predict first-line immune checkpoint inhibitor monotherapy-associated survival in PD-L1–high metastatic non–small cell lung cancer.

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To validate the Enhanced CT Response Score (eCTRS) as a predictor of survival in PD-L1–high mNSCLC patients receiving ICI monotherapy.
Conducted a retrospective analysis using a deidentified electronic health record database from Flatiron Health.
Included 205 PD-L1 high mNSCLC patients treated with ICI monotherapy, stratifying them into eCTRS High and Low groups based on imaging analysis.
Utilized Kaplan-Meier and Cox proportional hazards analyses to evaluate progression-free and overall survival.
PFS was improved in eCTRS High patients (HR 0.71, 95% CI 0.51–1.00, p=0.048), with a median of 231 days versus 88 days for eCTRS Low.
Significantly improved OS for eCTRS High patients (HR 0.56, 95% CI 0.39–0.80, p=0.001), median OS of 484 days versus 155 days for eCTRS Low.

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Randomized trial validates imaging biomarker predicting survival in PD-L1–high metastatic NSCLC, suggesting risk-adapted treatment strategies.

Parikh et al. (2026) studied this question.

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Randomized trial validates imaging biomarker predicting survival in PD-L1–high metastatic NSCLC, suggesting risk-adapted treatment strategies.