Prognostic and Predictive Role of PD-L1 Expression in Stage III Non-small Cell Lung Cancer Treated With Definitive Chemoradiation and Adjuvant Durvalumab.
Prognostic and Predictive Role of PD-L1 Expression in Stage III Non-small Cell Lung Cancer Treated With Definitive Chemoradiation and Adjuvant Durvalumab.
复制标题
DOI：
10.1016/j.ijrobp.2022.03.015
复制
发表时间：
2022-07-15
影响因子：
7
通讯作者：
Green, Michael D.
中科院分区：
文献类型：
--
作者：
Sankar, Kamya;Strohbehn, Garth W.;Zhao, Lili;Daniel, Victoria;Elliott, David;Ramnath, Nithya;Green, Michael D.
目前尚不清楚程序性死亡配体 1 (PD-L1) 的表达是否可以预测或预测接受根治性放化疗和辅助 durvalumab 治疗的 III 期非小细胞肺癌 (NSCLC) 患者的免疫治疗获益。我们测定了 2017 年 11 月至 2021 年 4 月期间美国退伍军人健康管理局 312 名接受根治性放化疗和至少一剂杜瓦鲁单抗辅助治疗的 312 名 III 期 NSCLC 患者的治疗前肿瘤 PD-L1 表达。将 PD-L1 表达亚组（<1%、1-49% 和 50-100%）的无进展生存期 (PFS) 和总生存期 (OS) 与 2015 年至 2016 年间 994 名未接受德瓦鲁单抗辅助治疗的 III 期 NSCLC 患者进行比较。109 例患者的 PD-L1 表达分别为 <1%、1-49% 和 50-100%分别有 (34.9%)、96 (30.7%) 和 107 (34.3%) 名患者。 PD-L1表达增加与更长的PFS（调整后的风险比[aHR]每25%表达绝对增加为0.84，95% CI 0.75-0.94，p=0.003）和OS（每25%表达绝对增加aHR 0.86，95% CI 0.74-0.99，p=0.036）相关。与无杜瓦鲁单抗组相比，PD-L1 50-100%（aHR 0.44，95% CI 0.32-0.60，p<0.001）和 PD-L1 1-49%（aHR 0.64，95% CI 0.47-0.86，p=0.003）的 PFS 更长，但 PD-L1 <1%（aHR 0.44，95% CI 0.32-0.60，p=0.003）的 PFS 更长0.84，95% CI 0.64–1.10，p=0.19）。 OS 也有类似的结果，无 durvalumab 组和 PD-L1 <1% 组之间没有显着差异（aHR 0.81，95% CI 0.58–1.13，p=0.22）。肿瘤 PD-L1 表达增加是接受 durvalumab 辅助治疗的 III 期 NSCLC 患者的 PFS 和 OS 的预后，而 PD-L1 表达 <1% 的患者从 durvalumab 辅助治疗中获得的益处可能有限。
It is unclear whether programmed death ligand-1 (PD-L1) expression is prognostic or predictive of immunotherapy benefit among stage III non-small-cell lung cancer (NSCLC) patients treated with definitive chemoradiation and adjuvant durvalumab. We determined pre-treatment tumor PD-L1 expression for 312 patients with stage III NSCLC treated with definitive chemoradiation and at least one dose of adjuvant durvalumab between November 2017 and April 2021 across the national Veterans Health Administration. Progression-free survival (PFS) and overall survival (OS) in PD-L1 expression subgroups (<1%, 1–49%, and 50–100%) were compared with 994 patients with stage III NSCLC treated without adjuvant durvalumab from 2015 to 2016. PD-L1 expression was <1%, 1–49%, and 50–100% in 109 (34.9%), 96 (30.7%), and 107 (34.3%) patients, respectively. Increasing PD-L1 expression was associated with longer PFS (adjusted hazard ratio [aHR] 0.84 per 25% absolute increase in expression, 95% CI 0.75-0.94, p=0.003) and OS (aHR 0.86 per 25% absolute increase in expression, 95% CI 0.74–0.99, p=0.036). Compared to the no-durvalumab group, PFS was longer for PD-L1 50–100% (aHR 0.44, 95% CI 0.32–0.60, p<0.001) and PD-L1 1–49% (aHR 0.64, 95% CI 0.47–0.86, p=0.003) but not PD-L1 <1% (aHR 0.84, 95% CI 0.64–1.10, p=0.19). Similar results were found for OS, with no significant difference between the no-durvalumab group and PD-L1 <1% (aHR 0.81, 95% CI 0.58–1.13, p=0.22). Increasing tumor PD-L1 expression is prognostic for PFS and OS among patients with stage III NSCLC treated with adjuvant durvalumab, and patients with PD-L1 expression <1% may have limited benefit from adjuvant durvalumab.
登录
查看更多内容
影响因子：
8.4
作者：
Desilets, Antoine;Blanc-Durand, Felix;Elkrief, Arielle
通讯作者：
Elkrief, Arielle
影响因子：
20.4
作者：
Goldstraw, Peter;Chansky, Kari;Bolejack, Vanessa
通讯作者：
Bolejack, Vanessa
影响因子：
5.2
作者：
Sankar K;Bryant AK;Strohbehn GW;Zhao L;Elliott D;Moghanaki D;Kelley MJ;Ramnath N;Green MD
通讯作者：
Green MD
IV期或复发性非小细胞肺癌中的一线Nivolumab。
DOI：
10.1056/nejmoa1613493
发表时间：
2017-06-22
期刊：
The New England journal of medicine
影响因子：
--
作者：
Carbone DP;Reck M;Paz-Ares L;Creelan B;Horn L;Steins M;Felip E;van den Heuvel MM;Ciuleanu TE;Badin F;Ready N;Hiltermann TJN;Nair S;Juergens R;Peters S;Minenza E;Wrangle JM;Rodriguez-Abreu D;Borghaei H;Blumenschein GR Jr;Villaruz LC;Havel L;Krejci J;Corral Jaime J;Chang H;Geese WJ;Bhagavatheeswaran P;Chen AC;Socinski MA;CheckMate 026 Investigators
通讯作者：
CheckMate 026 Investigators
影响因子：
4
作者：
Li, Huijuan;Xu, Yangyang;Lv, Tangfeng
通讯作者：
Lv, Tangfeng