{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:11:11Z","timestamp":1785186671608,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>At present, immunotherapy is a very promising treatment method for lung cancer patients, while the factors affecting response are still controversial. It is crucial to predict the efficacy of lung squamous carcinoma patients who received immunotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In our retrospective study, we enrolled lung squamous carcinoma patients who received immunotherapy at Beijing Chest Hospital from January 2017 to November 2021. All patients were grouped into two cohorts randomly, the training cohort (80% of the total) and the test cohort (20% of the total). The training cohort was used to build neural network models to assess the efficacy and outcome of immunotherapy in lung squamous carcinoma based on clinical information. The main outcome was the disease control rate (DCR), and then the secondary outcomes were objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 289 patients were included in this study. The DCR model had area under the receiver operating characteristic curve (AUC) value of 0.9526 (95%CI, 0.9088\u20130.9879) in internal validation and 0.9491 (95%CI, 0.8704\u20131.0000) in external validation. The ORR model had AUC of 0.8030 (95%CI, 0.7437\u20130.8545) in internal validation and 0.7040 (95%CI, 0.5457\u20130.8379) in external validation. The PFS model had AUC of 0.8531 (95%CI, 0.8024\u20130.8975) in internal validation and 0.7602 (95%CI, 0.6236\u20130.8733) in external validation. The OS model had AUC of 0.8006 (95%CI, 0.7995\u20130.8017) in internal validation and 0.7382 (95%CI, 0.7366\u20130.7398) in external validation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The neural network models show benefits in the efficacy evaluation of immunotherapy to lung squamous carcinoma patients, especially the DCR and ORR models. In our retrospective study, we found that neoadjuvant and adjuvant immunotherapy may bring greater efficacy benefits to patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.1024707","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T04:38:58Z","timestamp":1669610338000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Assessing the efficacy of immunotherapy in lung squamous carcinoma using artificial intelligence neural network"],"prefix":"10.3389","volume":"13","author":[{"given":"Siqi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyun","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanming","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhidong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21654","article-title":"cancer statistics, 2021","volume":"71","author":"Siegel","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.01.013","article-title":"Non-small cell lung cancer: epidemiology, screening, diagnosis, and treatment","volume":"94","author":"Duma","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"B4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jtho.2015.09.009","article-title":"The IASLC lung cancer staging project: Proposals for revision of the tnm stage groupings in the forthcoming (eighth) edition of the tnm classification for lung cancer","volume":"11","author":"Goldstraw","year":"2016","journal-title":"J Thorac Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s13046-014-0109-2","article-title":"Detection of ALK protein expression in lung squamous cell carcinomas by immunohistochemistry","volume":"33","author":"Wang","year":"2014","journal-title":"J Exp Clin Cancer Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2014.08.001","article-title":"Patterns in lung cancer incidence rates and trends by histologic type in the United States, 2004-2009","volume":"86","author":"Houston","year":"2014","journal-title":"Lung Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000109","article-title":"ALK\/EML4 fusion gene may be found in pure squamous carcinoma of the lung","volume":"9","author":"Cali\u00f2","year":"2014","journal-title":"J Thorac Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31818020eb","article-title":"The international epidemiology of lung cancer: geographical distribution and secular trends","volume":"3","author":"Youlden","year":"2008","journal-title":"J Thorac Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/0471142905.hg1011s57","article-title":"The Catalogue of Somatic Mutations in Cancer (COSMIC)","author":"Forbes","year":"2008","journal-title":"Curr Protoc Hum Genet"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.09.022","article-title":"Atezolizumab versus docetaxel in pretreated patients with nsclc: Final results from the randomized phase 2 poplar and phase 3 oak clinical trials","volume":"16","author":"Mazieres","year":"2021","journal-title":"J Thorac Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.05.001","article-title":"Five year survival update from keynote-010: Pembrolizumab versus docetaxel for previously treated, programmed death-ligand 1-positive advanced nsclc","volume":"16","author":"Herbst","year":"2021","journal-title":"J Thorac Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01605","article-title":"Five-year outcomes from the randomized, phase iii trials checkmate 017 and 057: Nivolumab versus docetaxel in previously treated non-small-cell lung cancer","volume":"39","author":"Borghaei","year":"2021","journal-title":"J Clin Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.769124","article-title":"Research progress of anti-pd-1\/pd-l1 immunotherapy related mechanisms and predictive biomarkers in nsclc","volume":"12","author":"Bie","year":"2022","journal-title":"Front Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1158\/1535-7163.MCT-14-0983","article-title":"PD-L1 expression as a predictive biomarker in cancer immunotherapy","volume":"14","author":"Patel","year":"2015","journal-title":"Mol Cancer Ther"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.15390","article-title":"Smoking history predicts high presence of tils and efficacy of pd-1 blockade in pd-l1 expression-negative non-small cell lung cancer patients","volume":"41","author":"Shimoda","year":"2021","journal-title":"Anticancer Res"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2019.07.004","article-title":"Safety and efficacy of pembrolizumab monotherapy in elderly patients with PD-L1-positive advanced non-small-cell lung cancer: Pooled analysis from the KEYNOTE-010, KEYNOTE-024, and KEYNOTE-042 studies","volume":"135","author":"Nosaki","year":"2019","journal-title":"Lung Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.3708","article-title":"Overall survival and long-term safety of nivolumab (anti-programmed death 1 antibody, bms-936558, ono-4538) in patients with previously treated advanced non-small-cell lung cancer","volume":"33","author":"Gettinger","year":"2015","journal-title":"J Clin Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e205842","DOI":"10.1001\/jamanetworkopen.2020.5842","article-title":"Development and validation of a deep learning model for non-small cell lung cancer survival","volume":"3","author":"She","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-18-2495","article-title":"Deep learning predicts lung cancer treatment response from serial medical imaging","volume":"25","author":"Xu","year":"2019","journal-title":"Clin Cancer Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018180237","article-title":"Development and validation of deep learning-based automatic detection algorithm for malignant pulmonary nodules on chest radiographs","volume":"290","author":"Nam","year":"2019","journal-title":"Radiology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0462-y","article-title":"Deep learning can predict microsatellite instability directly from histology in gastrointestinal cancer","volume":"25","author":"Kather","year":"2019","journal-title":"Nat Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.1095","article-title":"Development and validation of a deep learning-based automated detection algorithm for major thoracic diseases on chest radiographs","volume":"2","author":"Hwang","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"Mice: Multivariate imputation by chained equations in r","volume":"45","author":"Van Buuren","year":"2011","journal-title":"J Stat software"},{"key":"B24","first-page":"51","article-title":"Data structures for statistical computing in python","volume-title":"Proceedings of the 9th Python in Science Conference, Austin, TX","author":"McKinney","year":"2010"},{"key":"B25","article-title":"Scikit-learn: Machine learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"J Mach Learn Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12874-018-0482-1","article-title":"DeepSurv: personalized treatment recommender system using a Cox proportional hazards deep neural network","volume":"18","author":"Katzman","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"B27","first-page":"R 9525","volume-title":"Python reference manual","author":"vanRossum","year":"1995"},{"key":"B28","first-page":"32","article-title":"PyTorch: An imperative style, high-performance deep learning library","author":"Paszke","year":"2019","journal-title":"Adv Neur In"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2649-2","article-title":"Array programming with NumPy","volume":"585","author":"Harris","year":"2020","journal-title":"Nature"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1109\/MCSE.2007.55","article-title":"Matplotlib: A 2D graphics environment","volume":"9","author":"Hunter","year":"2007","journal-title":"Computing Sci Eng"},{"key":"B31","article-title":"Time-to-event prediction with neural networks and Cox regression","author":"Kvamme","year":"2019","journal-title":"arXiv preprint arXiv:190700825"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2105-12-77","article-title":"pROC: an open-source package for R and S+ to analyze and compare ROC curves","volume":"12","author":"Robin","year":"2011","journal-title":"BMC Bioinf"},{"key":"B33","article-title":"Package \u2018corrplot\u2019","volume":"56","author":"Wei","year":"2017","journal-title":"Statistician"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btu393","article-title":"Circlize implements and enhances circular visualization in R","volume":"30","author":"Gu","year":"2014","journal-title":"Bioinformatics"},{"key":"B35","article-title":"Package \u2018survminer\u2019","author":"Kassambara","year":"2017","journal-title":"Drawing Survival Curves using \u2018ggplot2\u2019(R Package version 03 1)"},{"key":"B36","volume-title":"R: A language and environment for statistical computing","author":"Team","year":"2013"},{"key":"B37","volume-title":"ggplot2: elegant graphics for data analysis","author":"Villanueva","year":"2019"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2015.05.011","article-title":"PD-1\/PD-L1 inhibitors","volume":"23","author":"Sunshine","year":"2015","journal-title":"Curr Opin In Pharmacol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32517-X","article-title":"Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial","volume":"389","author":"Rittmeyer","year":"2017","journal-title":"Lancet"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.823618","article-title":"Immunotherapy in lung cancer: Current landscape and future directions","volume":"13","author":"Mamdani","year":"2022","journal-title":"Front Immunol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00587-0","article-title":"Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial","volume":"387","author":"Fehrenbacher","year":"2016","journal-title":"Lancet"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801005","article-title":"Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer","volume":"378","author":"Gandhi","year":"2018","journal-title":"New Engl J Med"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504627","article-title":"Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer","volume":"373","author":"Brahmer","year":"2015","journal-title":"New Engl J Med"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507643","article-title":"Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer","volume":"373","author":"Borghaei","year":"2015","journal-title":"New Engl J Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613493","article-title":"First-line nivolumab in stage iv or recurrent non-small-cell lung cancer","volume":"376","author":"Carbone","year":"2017","journal-title":"New Engl J Med"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24955","article-title":"Program death ligand-1 immunocytochemistry in lung cancer cytological samples: A systematic review","volume":"50","author":"Satturwar","year":"2022","journal-title":"Diagn Cytopathol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2021.153605","article-title":"PD-L1 evaluation in head and neck squamous cell carcinoma: Insights regarding specimens, heterogeneity and therapy","volume":"226","author":"Paolino","year":"2021","journal-title":"Pathol Res Pract"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jpm12071073","article-title":"Atlas of pd-l1 for pathologists: indications, scores, diagnostic platforms and reporting systems","volume":"12","author":"Marletta","year":"2022","journal-title":"J Pers Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/jitc-2020-002118","article-title":"Non-invasive measurement of PD-L1 status and prediction of immunotherapy response using deep learning of PET\/CT images","volume":"9","author":"Mu","year":"2021","journal-title":"J Immunother Cancer"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606774","article-title":"Pembrolizumab versus chemotherapy for pd-l1-positive non-small-cell lung cancer","volume":"375","author":"Reck","year":"2016","journal-title":"New Engl J Med"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.04.011","article-title":"Sintilimab plus platinum and gemcitabine as first-line treatment for advanced or metastatic squamous nsclc: Results from a randomized, double-blind, phase 3 trial (orient-12)","volume":"16","author":"Zhou","year":"2021","journal-title":"J Thorac Oncol"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.11.018","article-title":"Camrelizumab plus carboplatin and paclitaxel as first-line treatment for advanced squamous nsclc (camel-sq): A phase 3 trial","volume":"17","author":"Ren","year":"2022","journal-title":"J Thorac Oncol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.06.015","article-title":"A randomized, placebo-controlled trial of pembrolizumab plus chemotherapy in patients with metastatic squamous nsclc: Protocol-specified final analysis of keynote-407","volume":"15","author":"Paz-Ares","year":"2020","journal-title":"J Thorac Oncol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1917346","article-title":"Atezolizumab for first-line treatment of pd-l1-selected patients with nsclc","volume":"383","author":"Herbst","year":"2020","journal-title":"N Engl J Med"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00650-1","article-title":"Sugemalimab versus placebo, in combination with platinum-based chemotherapy, as first-line treatment of metastatic non-small-cell lung cancer (GEMSTONE-302): interim and final analyses of a double-blind, randomised, phase 3 clinical trial","volume":"23","author":"Zhou","year":"2022","journal-title":"Lancet Oncol"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(20)30453-8","article-title":"Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial","volume":"21","author":"Provencio","year":"2020","journal-title":"Lancet Oncol"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2202170","article-title":"Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer","volume":"386","author":"Forde","year":"2022","journal-title":"N Engl J Med"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.04.012","article-title":"Three-year follow-up of neoadjuvant programmed cell death protein-1 inhibitor (sintilimab) in nsclc","volume":"17","author":"Zhang","year":"2022","journal-title":"J Thorac Oncol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.1024707\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T04:39:04Z","timestamp":1669610344000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.1024707\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,28]]},"references-count":58,"alternative-id":["10.3389\/fimmu.2022.1024707"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.1024707","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,28]]},"article-number":"1024707"}}