Abstract 6176: Identifying poor prognosis stage I lung adenocarcinoma patients through novel morphological biomarker based on computational pathology

Abstract Current practice for evaluating prognosis of resectable lung adenocarcinoma (LUAD) patients relies on the Tumor, Node, Metastasis staging system. Despite low relapse risk, post-recurrence survival in a stage I population is poor with a median post relapse survival of around 25 months. There is a need for a biomarker that can enrich for stage I patients with relapse risk to identify a population likely to benefit from adjuvant therapy. In this study, we aim to identify a predictive biomarker of relapse in early-stage lung cancer following surgical resection using AI-based computational pathology. The retrospective patient cohort analyzed in this study consisted of a total of 166 patients that underwent surgical resection for a clinical stage I LUAD. Out of these, 54 patients experienced disease recurrence within 5 years, and 112 patients had a confirmed disease-free period of at least 5 years post-surgery. For each patient, at least one digitized slide (average = 2. 46) stained with haematoxylin and eosin (H robustness of this evaluation was investigating using resampling methods, using 100 bootstrap samples and 100 repeats of 3-fold cross-validation, respectively. This allowed us to evaluate the prognostic value of the biomarkers with respect to 5-year relapse or death. We were able to identify the best prognostic biomarker for relapse to be the median weighted clustering coefficient (CC) across all cells in the TC area, which is derived from the graph-based analyses. The median CC was able to achieve a whole-cohort AUROC of 0. 695 (average cross-validated AUROC = 0. 675, 95% interval 61. 7%-70. 4%) as well as a relapse vs relapse-free Wilcoxon test p-value of 4. 65x10-5 (bootstrapped average = 0. 0002). In addition, we were also able to demonstrate that the biomarker shows some relation to the architecture patterns. Citation Format: Florian J. Song, Alma Andoni, Manal Kordahi, Sara Batelli, Armin Meier, Markus Schick, Emilie Mahieu, Günter Schmidt, Claire E. Myers, Michael Abadier, Abjihit Dasgupta, Christopher Abbosh, Darren Hodgson, Michèle Orain, Fabien C. Lamaze, Yohan Bossé, Philippe Joubert. Identifying poor prognosis stage I lung adenocarcinoma patients through novel morphological biomarker based on computational pathology abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 6176.