Change in tumor mean diameter on noncontrast CT predicts pathological response to neoadjuvant immunotherapy in NSCLC

Change in mean tumor diameter on noncontrast CT showed AUC 0.83 for major pathological response to neoadjuvant immunotherapy in resectable NSCLC, with 76% sensitivity and 84% specificity, and numerically outperformed RECIST 1.1 (79.2% vs 72.9% accuracy).

• In multivariable analysis, Δmean diameter was the only independent predictor of major pathological response (OR 11.91, 95% CI 1.52–93.11, p=0.018).
• Findings are hypothesis-generating; internal and external validation required before clinical use.

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