This project is based on the hypothesis that CTTA features can correlate with clinical outcome of IV stage melanomapatients undergoing anti-PD1 immunotherapy. Radiogenomic analysis refers to the integration of radiophenotypes andgenomic data in order to find radiogenomic associations.These informations will support clinical decision to prevent administration of treatment to non-responder patients, allowingto reduce costs of unnecessary treatments, limit potential therapies side-effects and foster the introduction of alternativetherapies.As an example, tumors exhibit genomic and phenotypic heterogeneity, which has prognostic significance and may influenceresponse to therapy.CTTA combined with molecular tumor profile can estimate the level of heterogeneity of the tumor, as well as identify sub-regions with different microenvironment, and correlate them with treatment response.

1. To explore a new quantitative and high sensitive radiogenomic approach for monitoring immunotherapy in metastatic melanoma patients. Knowledge of the relationships between CT texture features and treatment response can assistphysicians to early differentiate responder to non responder patients and to eventually introduce alternative, potentiallymore effective therapies.
2. To investigate the added value of the combined use of molecular data (ctDNA) and CTTA texture features mightintroduce novel potential more robust biomarkers for predicting treatment response in metastatic melanoma patients. Thisradiogenomic approach could improve personalized clinical decision process.
3. To explore a correlation between data extrapolated from tissue samples (TMB and PD-L1) and both CTTA features andliquid biopsy molecular data might support clinical decision process in metastatic melanoma patients

The total cost of the grant-eligible project is € 449.000,00.