Department of Respiratory Medicine, The Third People's Hospital of Hangzhou, Hangzhou, China.
Department of Allergy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Medicine (Baltimore). 2021 Aug 27;100(34):e27038. doi: 10.1097/MD.0000000000027038.
Whether programmed death-ligand 1 (PD-L1) expression could predict the outcome of tyrosine kinase inhibitor (TKI) treatment and prognosis of epidermal growth factor receptor (EGFR)-mutant nonsmall cell lung cancer (NSCLC) is remaining controversial.Potential studies were search from PubMed, Embase, and Web of Science databases. Pooled odds ratio of objective response rate was used to describe the relationship between PD-L1 expression and primary resistance to EGFR-TKIs. Pooled hazard ratios (HRs) of progression-free survival (PFS) and overall survival (OS) were included to assess the effects of PD-L1 status on the outcome of EGFR-TKI treatment and survival of EGFR-mutant NSCLCs.Eighteen eligible studies (1986 EGFR-mutant NSCLCs) were included in this meta-analysis. Positive PD-L1 expression correlated with lower objective response rate of EGFR-TKI treatment (odds ratio [95% confidence interval {CI}] = 0.52 [0.28-0.98], P = .043), while PFS (adjusted HR [95% CI] = 1.49 [0.96-1.89], P = .332) and OS (HR [95% CI] = 1.24 [0.70-2.20], P = .456) of EGFR-TKI treatment did not correlated with PD-L1 status. Furthermore, PD-L1 expression was not a predictive biomarker for the OS (HR [95% CI] = 1.43 [0.98-2.08], P = .062) in overall EGFR-mutant cohort.Positive PD-L1 expression indicated a higher incidence of primary resistance, but did not correlate with the PFS or OS of EGFR-TKI therapy. In addition, PD-L1 expression was unlikely a predictive biomarker for prognosis of EGFR-mutant NSCLCs.
程序性死亡配体 1（PD-L1）表达能否预测酪氨酸激酶抑制剂（TKI）治疗的疗效和表皮生长因子受体（EGFR）突变型非小细胞肺癌（NSCLC）的预后仍存在争议。从 PubMed、Embase 和 Web of Science 数据库中搜索潜在的研究。使用客观缓解率的合并优势比来描述 PD-L1 表达与 EGFR-TKI 原发性耐药之间的关系。纳入无进展生存期（PFS）和总生存期（OS）的合并风险比（HR）来评估 PD-L1 状态对 EGFR-TKI 治疗效果和 EGFR 突变型 NSCLC 生存的影响。这项荟萃分析纳入了 18 项符合条件的研究（1986 例 EGFR 突变型 NSCLC）。PD-L1 阳性表达与 EGFR-TKI 治疗的客观缓解率较低相关（优势比[95%置信区间{CI}] = 0.52[0.28-0.98]，P = 0.043），而 PFS（调整后的 HR[95%CI] = 1.49[0.96-1.89]，P = 0.332）和 OS（HR[95%CI] = 1.24[0.70-2.20]，P = 0.456）与 PD-L1 状态无关。此外，PD-L1 表达不是整体 EGFR 突变型队列中 OS（HR[95%CI] = 1.43[0.98-2.08]，P = 0.062）的预测生物标志物。PD-L1 阳性表达提示原发性耐药发生率较高，但与 EGFR-TKI 治疗的 PFS 或 OS 无关。此外，PD-L1 表达不太可能是 EGFR 突变型 NSCLC 预后的预测生物标志物。
