AI volumetric brain-met response may better predict PFS in ALK+ NSCLC

In an exploratory post hoc analysis of the Phase III CROWN trial (NCT03052608), researchers evaluated an FDA-cleared AI tool for measuring brain metastases in 72 patients with untreated ALK+ advanced NSCLC and baseline brain metastases. Across 666 MRI timepoints, AI and neuroradiologists showed high agreement in conventional target-lesion measurements (r=0.94). But when AI tracked the volume of all 322 brain metastases, greater early tumor shrinkage was associated with longer systemic PFS (adjusted HR 0.44, 95% CI 0.23–0.86), while early response based on target-lesion diameters was not (HR 0.64, 95% CI 0.29–1.41). Adding AI volumetric response to clinical factors also improved PFS prediction (AUC 0.71 vs 0.55).