{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:43:42Z","timestamp":1792219422819,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with very high\u2010risk (VHR), nonmuscle\u2013invasive bladder cancer (NMIBC) who are ineligible for or decline radical cystectomy face limited treatment options. Immune checkpoint inhibitor\u2013based regimens have demonstrated promise but lack reliable biomarkers to guide patient selection. The objective of this study was to identify magnetic resonance imaging\u2013derived radiomic phenotypes predictive of treatment response to immune checkpoint inhibitor\u2013based therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The authors retrospectively analyzed two prospective cohorts of patients with extensive VHR NMIBC: a single\u2010center derivation cohort from the TRUCE\u201002 trial (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a059) and a multicenter validation cohort from the TRUCE\u201022 trial (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a037). All patients received tislelizumab and nanoparticle albumin\u2010bound paclitaxel every 3 weeks. Complete response (CR) was assessed at 3 months. Radiomic features were extracted from baseline, T2\u2010weighted images, and a hybrid framework integrating supervised feature selection with unsupervised clustering was used to identify imaging phenotypes. Associations with CR, progression\u2010free and overall survival, and immune\u2010related transcriptional signatures were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three radiomic clusters were identified: immune\u2010excluded (cluster 0), immune\u2010intermediate (cluster 1), and immune\u2010inflamed (cluster 2). In the derivation cohort, cluster 2 had a significantly higher CR rate (82.8%) than cluster 0 (21.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.001), a pattern that was validated in TRUCE\u201022 (83.3% vs. 22.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.008). The cluster\u2010only model achieved the highest predictive performance for CR in both the derivation (area under the receiver operating characteristic curve, 0.77) and validation (area under the receiver operating characteristic curve, 0.78) cohorts. Cluster 2 had better progression\u2010free and overall survival. Transcriptomic and immunofluorescence analyses revealed functional immune suppression in cluster 0, including reduced CD8\u2010positive, phosphorylated STAT1\u2013positive T cells.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with very high\u2010risk NMIBC, magnetic resonance imaging\u2013derived radiomic phenotypes can be used to stratify responses to immunochemotherapy and capture functional immune states. Noninvasive radiomic profiling may guide precision treatment selection in patients who are unfit for radical cystectomy, and prospective validation is warranted before clinical adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70498","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T09:28:38Z","timestamp":1782293318000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Magnetic resonance imaging radiomic phenotypes stratify response and define immune states in very high\u2010risk, nonmuscle\u2013invasive bladder cancer treated with tislelizumab plus nanoparticle albumin\u2010bound paclitaxel"],"prefix":"10.1002","volume":"132","author":[{"given":"Shiwang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Urology The Second Hospital of Tianjin Medical University  Tianjin China"},{"name":"Tianjin Key Laboratory of Urology Tianjin 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