PD-L1 Expression in Circulating Tumor Cells as a Promising Prognostic Biomarker in Advanced Non-small-cell Lung Cancer Treated with Immune Checkpoint Inhibitors
PD-L1 Expression in Circulating Tumor Cells as a Promising Prognostic Biomarker in Advanced Non-small-cell Lung Cancer Treated with Immune Checkpoint Inhibitors
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DOI：
10.1016/j.cllc.2021.03.005
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发表时间：
2021-09-20
影响因子：
3.6
通讯作者：
Ardizzoni, Andrea
中科院分区：
文献类型：
--
作者：
Dall'Olio, Filippo G.;Gelsomino, Francesco;Ardizzoni, Andrea
Biomarkers for immunotherapy represent a clinical need. Circulating tumor cells (CTCs) are associated with a worse outcome. This is a prospective single-center cohort study enrolling 39 patients with non-small-cell lung cancer. A median overall survival of 2.2, 3.7, and 16 months was observed in patients with negative CTC, positive CTC, and no CTC detectable, respectively. No correlation was found between PD-L1 expression on CTCs and on tumor tissue. CTCs were correlated with baseline tumor size. PD-L1 on CTCs is a promising biomarker.Background: Circulating tumor cells (CTCs) are a promising source of biological information in cancer. Data correlating PD-L1 expression in CTCs with patients' response to immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer (NSCLC) are still lacking. Methods: This is a prospective single-center cohort study enrolling patients with advanced NSCLC. CTCs were identified and counted with the CellSearch system. PD-L1 expression on CTCs was assessed with phycoerythrin-conjugated anti-human PD-L1 antibody, clone MIH3 (BioLegend, USA). Primary endpoint was the correlation between the CTCs PD-L1 expression and overall survival (OS). Among secondary objectives, we evaluated the correlation between PD-L1 expression on CTCs and matched tumor tissue and the correlation of CTC number and baseline tumor size (BTS). Results: Thirty-nine patients treated with anti-PD-1/PD-L1 agents as second- or third-line therapy were enrolled. Patients were divided into 3 groups: no CTC detectable (CTCnull, n = 15), PD-L1 positive CTC (CTCpos, n = 13), and PD-L1 negative CTC (CTCneg, n = 11). Median OS in patients with CTCneg was 2.2 months, 95% confidence interval (CI), 0.8-3.6 (reference) versus 3.7 months, 95% CI, 0.1-7.5 (hazard ratio [HR] 0.33; 95% CI, 0.13-0.83; P=.019) in patients with CTCpos versus 16.0 months, 95% CI, 2.2-29.8 (HR 0.17; 95% CI, 0.06-0.45; P
