PD-L1 表达对一线克唑替尼治疗晚期 ROS1 重排 NSCLC 疗效的影响。

Impact of PD-L1 expression on the efficacy of first-line crizotinib in advanced ROS1-rearranged NSCLC.

机构信息

Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Lung Cancer. 2024 Aug;194:107892. doi: 10.1016/j.lungcan.2024.107892. Epub 2024 Jul 14.

DOI:10.1016/j.lungcan.2024.107892

PMID:39018704

Abstract

BACKGROUND

The predictive value of programmed death-ligand 1 (PD-L1) expression for the efficacy of tyrosine kinase inhibitors (TKIs) in patients with advanced ROS1-rearranged non-small cell lung cancer (NSCLC) remains underexplored. This study analyzed patients with advanced NSCLC harboring ROS1 rearrangements who received first-line crizotinib to evaluate the correlation between baseline PD-L1 expression and crizotinib efficacy.

METHODS

In this study, the clinical data from 371 patients diagnosed with ROS1-rearranged NSCLC at Shanghai Chest Hospital between November 2017 and December 2022 were reviewed. The patients were categorized into three groups according to the baseline PD-L1 expression: tumor proportion score (TPS) <1%, TPS 1 %-49 %, and TPS≥50 %. The objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) following first-line crizotinib treatment were measured.

RESULTS

A total of 64 patients were included in the analysis, with 16 patients in the TPS<1% group, 22 in the TPS 1 %-49 % group, and 26 in the TPS≥50 % group. The overall DCR was 100 %, and the overall ORR was 76.5 %. The ORRs were 81.2 % (13/16) in the TPS<1% group, 63.6 % (14/22) in the TPS 1 %-49 % group, and 84.6 % (22/26) in the TPS≥50 % group (p = 0.218). The median PFS across all patients was 20.21 months (95 % CI: 15.71-24.71), with a median PFS of 28.96 months (95 % CI: 19.87-38.04) in the TPS<1% group, 17.56 months (95 % CI: 12.25-22.86) in the TPS 1 %-49 % group, and 25.85 months (95 % CI: 18.52-33.17) in the TPS≥50 % group (p = 0.100). The median PFS for patients with CD74 fusion was 18.23 months (95 % CI: 15.24-21.22), while those with non-CD74 fusion exhibited a PFS of 16.49 months (95 % CI: 9.75-23.23) (p = 0.359).

CONCLUSION

Patients with advanced ROS1-rearranged NSCLC were found to benefit from first-line crizotinib treatment, irrespective of baseline PD-L1 expression.

摘要

背景

程序性死亡配体 1（PD-L1）表达对接受酪氨酸激酶抑制剂（TKI）治疗的晚期 ROS1 重排非小细胞肺癌（NSCLC）患者疗效的预测价值仍未得到充分探索。本研究分析了接受一线克唑替尼治疗的晚期 ROS1 重排 NSCLC 患者，以评估基线 PD-L1 表达与克唑替尼疗效之间的相关性。

方法

本研究回顾了 2017 年 11 月至 2022 年 12 月期间在上海胸科医院诊断为 ROS1 重排 NSCLC 的 371 例患者的临床数据。患者根据基线 PD-L1 表达分为三组：肿瘤比例评分（TPS）<1%、TPS 1%-49%和 TPS≥50%。测量一线克唑替尼治疗后的客观缓解率（ORR）、疾病控制率（DCR）和无进展生存期（PFS）。

结果

共纳入 64 例患者，其中 TPS<1%组 16 例，TPS 1%-49%组 22 例，TPS≥50%组 26 例。总 DCR 为 100%，总 ORR 为 76.5%。ORR 在 TPS<1%组为 81.2%（13/16），TPS 1%-49%组为 63.6%（14/22），TPS≥50%组为 84.6%（22/26）（p=0.218）。所有患者的中位 PFS 为 20.21 个月（95%CI：15.71-24.71），TPS<1%组中位 PFS 为 28.96 个月（95%CI：19.87-38.04），TPS 1%-49%组为 17.56 个月（95%CI：12.25-22.86），TPS≥50%组为 25.85 个月（95%CI：18.52-33.17）（p=0.100）。CD74 融合患者的中位 PFS 为 18.23 个月（95%CI：15.24-21.22），而非 CD74 融合患者的中位 PFS 为 16.49 个月（95%CI：9.75-23.23）（p=0.359）。