程序性死亡配体 1 表达对单药派姆单抗治疗的非小细胞肺癌患者总生存期的影响。
Impact of PD-L1 Expression on the Overall Survival of Patients With Non-small Cell Lung Cancer Treated With Single-agent Pembrolizumab.
机构信息
Department of Pneumology and Phthiseology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic;
Department of Lung Cancer and Chest Tumours Maria Sklodowska-Curie National Research Institute of Cancer, Warsaw, Poland.
出版信息
In Vivo. 2024 Sep-Oct;38(5):2434-2440. doi: 10.21873/invivo.13712.
BACKGROUND/AIM: Cemiplimab in patients with non-small cell lung cancer (NSCLC) with PD-L1 (programmed death ligand type 1) expression ≥50% showed a significant improved overall survival (OS) with increasing expression of PD-L1. To our knowledge there exist no similar data published for pembrolizumab regarding the increased OS in relation to the PD-L1 expression. Therefore, the objective of our study was to determine whether improvement in OS reflects increased expression levels of PD-L1 (≥50%) in patients with NSCLC.
PATIENTS AND METHODS
Retrospective data from 9 Czech and 1 Polish comprehensive oncology Centers were used. All patients with stage IV NSCLC and PD-L1 expression ≥50% treated with pembrolizumab in daily practice were included. The groups of patients according to the expression of PD-L1 were determined as follows: PD-L1 50-59%, 60-69%, 70-79%, 80-89% and 90-100%. The log-rank test and the Cox regression model were used to compare survival between study groups.
RESULTS
A total of 617 patients were included in the study. We did not observe a statistically significant difference in OS between groups of patients with different levels of PD-L1 expression in the pooled comparison (p=0.445). Furthermore, we did not observe a statistically significant difference even when comparing OS in patients with PD-L1expression of 50-59% (reference) with the group of other patients according to the level of expression of PD-L1 in the Cox regression model including the effect covariates.
CONCLUSION
PD-L1 expression showed no significant effect on OS in patients with NSCLC with PD-L1≥50% treated with pembrolizumab.
背景/目的：在 PD-L1（程序性死亡配体 1）表达≥50%的非小细胞肺癌（NSCLC）患者中，使用西米普利单抗治疗可显著提高总生存期（OS），且 PD-L1 的表达水平越高，OS 改善越显著。据我们所知，关于 pembrolizumab 与 PD-L1 表达相关的 OS 增加，尚无类似数据发表。因此，我们的研究目的是确定在 NSCLC 患者中，OS 的改善是否反映了 PD-L1（≥50%）表达水平的增加。
患者和方法
回顾性分析了来自 9 个捷克和 1 个波兰综合肿瘤中心的数据。所有在日常实践中接受 pembrolizumab 治疗、且 PD-L1 表达≥50%的 IV 期 NSCLC 患者均被纳入研究。根据 PD-L1 表达情况将患者分为以下几组：PD-L1 表达为 50-59%、60-69%、70-79%、80-89%和 90-100%。采用对数秩检验和 Cox 回归模型比较研究组间的生存情况。
结果
共有 617 例患者纳入研究。在汇总比较中，不同 PD-L1 表达水平组间的 OS 差异无统计学意义（p=0.445）。此外，即使在 Cox 回归模型中比较 PD-L1 表达为 50-59%（参照组）与其他 PD-L1 表达水平组的患者 OS 时，也未观察到统计学差异，该模型纳入了效应协变量。
结论
在 PD-L1≥50%的 NSCLC 患者中，PD-L1 表达对 pembrolizumab 治疗的 OS 无显著影响。
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