# Prospective validation of a radiomics-based multi-modal predictive model for metastatic non-small cell lung cancer patients treated with PD-1 immunotherapy

> **NIH NIH R44** · ONC.AI, INC. · 2024 · $1,625,000

## Abstract

Summary
PD-(L)1 checkpoint inhibitors are an effective class of oncology therapeutics, where some
patients with non-small cell lung, bladder cancer and melanoma demonstrate durable responses
and significant increases in overall survival. This form of therapy, however, is accompanied by
several significant disadvantages including; unpredictable and low activity (15-20% response-
rates) for most patients, high therapy cost ($150,000 per year) and serious immune-related
adverse events that often result in hospitalization or stoppage of therapy. There have been a
variety of approaches attempting to accurately predict response to PD-(L)1 immunotherapy such
as PD-L1 immunohistochemistry staining, tissue or liquid-biopsy based genomic signatures such
as TMB (tumor mutational burden), and multiplex immunohistochemistry / immunofluorescence.
None of these approaches have yielded results that materially improve patient selection. Onc.AI
is developing the first universal radiomics-based multi-modal biomarker solution to predict
response to PD-(L)1 immunotherapy. By leveraging novel imaging biomarkers in combination
with proteomic, genomic and clinical features, all tumors comprising a patient’s tumor burden can
be interrogated through the application of advanced Machine Learning and computer vision
techniques on CT scans alongside routine lab tests and patient characteristics. This approach
avoids the shortcomings of tissue or blood-based biomarkers, which are not able to accurately
capture and account for variable intra/inter tumor heterogeneity, diversity and immunogenicity
that characterizes metastatic cancer. Achieving accurate prediction of PD-(L)1 ICI therapy
response will enable a host of high-impact clinical applications such as -- identification of hyper-
progressing patients (patients where tumor growth accelerates as a result of PD-(L)1 ICI);
improved selection of patients (predicted non-responders) who would benefit from chemotherapy
or additional immunotherapy added to a PD-(L)1 ICI backbone; appropriately de-escalating
combination therapy to minimize toxicity for predicted responders (switching patient from PD-
(L)1/chemo to PD-(L)1 monotherapy); and informing continuation of PD-(L)1 therapy at the 12 to
24 month mark based on radiomic signatures more advanced than tumor shrinkage. Each of
these applications has the potential to either significantly improve patient outcomes and/or
optimize the health-economic profile of PD-(L)1 treatment.
Onc.AI’s proposal has three specific aims:
Aim 1: Validate predictive models in a multi-institutional prospective clinical study.
We will validate the efficacy of radiomics-based multi-modal models in predicting response to
PD-1/PD-L1 ICI therapy in EGFR/ALK mutation-negative stage IV NSCLC patients and in
adjudicating concurrent chemotherapy.
Aim 2: Evaluate key performance characteristics and biological basis of radiomics-based
predictive models.
We will evaluate our production candidate models on secondary...

## Key facts

- **NIH application ID:** 11007396
- **Project number:** 1R44CA291456-01A1
- **Recipient organization:** ONC.AI, INC.
- **Principal Investigator:** Petr Jordan
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,625,000
- **Award type:** 1
- **Project period:** 2024-09-13 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11007396

## Citation

> US National Institutes of Health, RePORTER application 11007396, Prospective validation of a radiomics-based multi-modal predictive model for metastatic non-small cell lung cancer patients treated with PD-1 immunotherapy (1R44CA291456-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11007396. Licensed CC0.

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