Parra-Medina Rafael, Castañeda-González Juan Pablo, Montoya Luisa, Gómez-Gómez María Paula, Clavijo Cabezas Daniel, Plazas Vargas Merideidy
Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
Transl Lung Cancer Res. 2024 Jul 30;13(7):1660-1671. doi: 10.21037/tlcr-24-223. Epub 2024 Jul 25.
Programmed cell death ligand 1 (PD-L1) expression in non-small cell lung carcinoma (NSCLC) is a crucial factor in predicting responses to immunotherapy. This systematic review and meta-analysis focuses on the prevalence of PD-L1 expression and clinicopathological features among Hispanic/Latino (H/L) populations.
Embase, LILACS, Medline, and Virtual Health Library were searched for studies that evaluated the prevalence of PD-L1 in H/L patients. The protocol was submitted to PROSPERO with ID CRD42023488547. We employed the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses to assess the methodological quality and applicability of the included studies. Meta-analyses were done to determine the prevalence using a random effects model.
The meta-analysis, encompassing 21 articles with 16,486, revealed that 80.2% of patients had PD-L1 expression data available (n=13,222). The prevalence calculated of PD-L1 expression in Latino NSCLC patients was 55% [95% confidence interval (CI): 0.54-0.55], with 31% (95% CI: 0.27-0.36) showing a tumoral proportion score (TPS) of 1-49%, and 23% (95% CI: 0.16-0.30) registering a TPS ≥50%. Higher expression was observed in male gender, smoking, adenocarcinoma subtypes, poor tumor differentiation, and advanced stages. PD-L1 expression was most frequent in wild-type status (82.5%) with a odds ratio (OR) 1.54 (95% CI: 1.24-1.92) and PD-L1 expression was associated with positive (OR =1.54; 95% CI: 1.24-1.92).
This meta-analysis provides a comprehensive overview of PD-L1 expression in NSCLC in the H/L population. The findings underscore the significant prevalence of PD-L1 expression and emphasize the relevance of immunotherapy in this population. Understanding the clinicopathological features associated with PD-L1 expression can contribute to tailored treatment strategies for NSCLC in Latin America.
非小细胞肺癌（NSCLC）中程序性细胞死亡配体1（PD-L1）的表达是预测免疫治疗反应的关键因素。本系统评价和荟萃分析聚焦于西班牙裔/拉丁裔（H/L）人群中PD-L1表达的患病率及临床病理特征。
检索Embase、LILACS、Medline和虚拟健康图书馆，查找评估H/L患者中PD-L1患病率的研究。该方案已提交至国际前瞻性系统评价注册库（PROSPERO），注册号为CRD42023488547。我们采用乔安娜·布里格斯循证卫生保健中心系统评价与研究整合方法学质量和适用性评价清单，评估纳入研究的方法学质量和适用性。采用随机效应模型进行荟萃分析以确定患病率。
荟萃分析纳入21篇文章，共16486例患者，结果显示80.2%的患者有PD-L1表达数据（n=13222）。拉丁裔NSCLC患者中PD-L1表达的患病率为55%[95%置信区间（CI）：0.54-0.55]，其中31%（95%CI：0.27-0.36）的肿瘤比例评分（TPS）为1%-49%，23%（95%CI：0.16-0.30）的TPS≥50%。在男性、吸烟、腺癌亚型、肿瘤分化差和晚期患者中观察到更高的表达。PD-L1表达在野生型状态下最为常见（82.5%），优势比（OR）为1.54（95%CI：1.24-1.92），且PD-L1表达与阳性相关（OR=1.54；95%CI：1.24-1.92）。
本荟萃分析全面概述了H/L人群NSCLC中PD-L1的表达情况。研究结果强调了PD-L1表达的显著患病率，并强调了免疫治疗在该人群中的相关性。了解与PD-L1表达相关的临床病理特征有助于为拉丁美洲NSCLC患者制定个性化的治疗策略。
