SP263评估的程序性死亡受体配体1（PD-L1）表达对接受放化疗的Ⅲ期非小细胞肺癌（NSCLC）患者预后影响的评估

Evaluation of the Prognostic Impact of SP263-Evaluated PD-L1 Expression in Patients with Stage III Non-Small Cell Lung Cancer (NSLC) Treated with Radio-Chemotherapy.

作者信息

Wagner Jan Nicolai, Roeper Julia, Heukamp Lukas, Falk Markus, Willborn Kay, Griesinger Frank

机构信息

Faculty VI-Medicine and Health Sciences, European Medical School, University Oldenburg, Ammerländer Heerstraße 114-118, 26129 Oldenburg, Germany.

Hematopathology Hamburg, Fangdieckstraße 75A, 22547 Hamburg, Germany.

出版信息

Biomedicines. 2024 Mar 19;12(3):688. doi: 10.3390/biomedicines12030688.

BACKGROUND

The PACIFIC study showed that after radio-chemotherapy, patients with NSCLC derived a benefit in PFS and OS when treated with durvalumab. This effect was limited to patients with a PD-L1 expression of >1%, partly because the outcome in the observational control arm was surprisingly favorable. Thus, it could be speculated that a lack of PD-L1 expression confers a favorable outcome for patients with stage III NSCLC.

METHODS

Clinical data, PD-L1 expression, predictive blood markers, and the outcomes of 99 homogeneously treated patients with stage III NSCLC were retrospectively captured. Statistical analyses using the log rank test were performed.

RESULTS

The median OS of patients with an expression of PD-L1 < 1% was 20 months (CI 10.5-29.5) and the median OS of patients with an expression of PD-L1 ≥ 1% was 28 months (CI 16.5-39.2) ( = 0.734). The median PFS of patients with an expression of PD-L1 < 1% was 9 months (CI 6.3-11.6) and the median PFS of patients with an expression of PD-L1 ≥ 1% was 12 months (CI 9.8-14.2) ( = 0.112).

CONCLUSIONS

The assumption that the lack of PD-L1 expression represents a favorable prognostic factor after radio-chemotherapy vs. PD-L1 expression > 1% was not confirmed.

背景

PACIFIC研究表明，非小细胞肺癌（NSCLC）患者在接受放化疗后，使用度伐利尤单抗治疗可在无进展生存期（PFS）和总生存期（OS）方面获益。这种效应仅限于程序性死亡配体1（PD-L1）表达>1%的患者，部分原因是观察性对照臂的结果出奇地良好。因此，可以推测，PD-L1表达缺失对III期NSCLC患者来说是一个良好的预后因素。

方法

回顾性收集了99例接受同质化治疗的III期NSCLC患者的临床数据、PD-L1表达、预测性血液标志物及预后情况。采用对数秩检验进行统计分析。

结果

PD-L1表达<1%的患者的中位总生存期为20个月（可信区间10.5 - 29.5），PD-L1表达≥1%的患者的中位总生存期为28个月（可信区间16.5 - 39.2）（P = 0.734）。PD-L1表达<1%的患者的中位无进展生存期为9个月（可信区间6.3 - 11.6），PD-L1表达≥1%的患者的中位无进展生存期为12个月（可信区间9.8 - 14.2）（P = 0.112）。