5yr
Programmed cell death ligand-1 expression and survival in a cohort of patients with non-small cell lung cancer receiving first-line through third-line therapy in Denmark - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/34217914/
doi: 10.1016/j.canep.2021.101976. Online ahead of print. 1 EpidStrategies, Rockville, MD, USA. Electronic address: [email protected]. 2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: [email protected]. 3 AstraZeneca, Gaithersburg, MD, USA. Electronic address: [email protected]. 4 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: [email protected].
• Conclusion/Relevance: “No association was observed between PD-L1 TC ≥ 25 % and OS in any therapy line. PD-L1 IC ≥ 25 % may confer survival benefit among some patients who reach second-line therapy …. Our results are broadly generalizable to patients with NSCLC eligible for systemic therapies for all stages combined. This distinction is important because only 40 % of newly diagnosed patients with NSCLC during the 2000–2012 period survived a year after diagnosis, and fewer were eligible for therapy due to advanced disease or deteriorated health status at diagnosis.”
• In the current study, researchers assessed PD-L1 expression on tumor cells (TCs) or immune cells (ICs) in an NSCLC cohort to determine associations between PD-L1 expression and overall survival (OS) per EGFR and KRAS mutation status.
• This retrospective cohort consisted of Danish patients aged 18 years or more diagnosed with NSCLC on first- (N = 491), second- (N = 368), or third-line (N = 498) therapy. Data were extracted from population-based medical registries. The authors identified high PD-L1 expression as ≥25 % of TCs or ICs based on first diagnostic biopsy or surgical resection.
• “Findings from this large study of patients with NSCLC suggest that PD-L1 expression at ≥25 % is not prognostic for OS,” the authors wrote. “Patient characteristics were similar regardless of PD-L1 expression. TC expression did not vary by EGFR or KRAS mutation status, although we noted some variation for IC expression according to treatment line. The presence of an EGFR mutation was associated with decreased mortality across all lines of therapy, whereas KRAS mutations were associated with increased mortality risk.”
• One limitation of the current study was that biomarker status was assessed at the time of diagnosis vs at initiation of each therapy line due to the availability of archived tissue. Notably, between 70 % and 80 % of patients in this study were diagnosed with Stage I–III NSCLC, which means that tumor evolution or change in biomarker expression/mutation acquisition over time could have transpired.