Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer

Abstract Background Superior outcomes have been obtained for neoadjuvant treatment with immune checkpoint inhibitors (ICI) plus chemotherapy over neoadjuvant chemotherapy alone, especially in patients with high programmed cell death ligand 1 (PD‐L1) expression. However, it is not always possible to...

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Main Authors: Shuta Ohara, Kenichi Suda, Akira Hamada, Masato Chiba, Masaoki Ito, Masaki Shimoji, Toshiki Takemoto, Junichi Soh, Yasuhiro Tsutani
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.15453
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author Shuta Ohara
Kenichi Suda
Akira Hamada
Masato Chiba
Masaoki Ito
Masaki Shimoji
Toshiki Takemoto
Junichi Soh
Yasuhiro Tsutani
author_facet Shuta Ohara
Kenichi Suda
Akira Hamada
Masato Chiba
Masaoki Ito
Masaki Shimoji
Toshiki Takemoto
Junichi Soh
Yasuhiro Tsutani
author_sort Shuta Ohara
collection DOAJ
description Abstract Background Superior outcomes have been obtained for neoadjuvant treatment with immune checkpoint inhibitors (ICI) plus chemotherapy over neoadjuvant chemotherapy alone, especially in patients with high programmed cell death ligand 1 (PD‐L1) expression. However, it is not always possible to obtain sufficient tumor specimens for biomarker testing before surgery. In this study, we explored clinical factors that can predict high PD‐L1 expression. Methods We retrospectively enrolled 340 lung cancer patients who received pulmonary resection between 2014 and 2023 and who had PD‐L1 expression data. Chi‐squared tests and logistic regression analyses were used to identify clinical factors associated with high PD‐L1 status. Results Univariable and multivariable analyses revealed that smoking, high maximum standardized uptake value (SUVmax) of 18F‐fluorodeoxyglucose positron emission computed tomography (18F‐FDG PET/CT), and high plasma fibrinogen are independent predictors of high PD‐L1 expression. A predictive score for high PD‐L1 expression (ranging from 0 to 3) was developed based on these parameters. Notably, only 5% of patients with a score of 0 exhibited high PD‐L1 expression, whereas this proportion increased to 53% for patients with a score of 3. Conclusion These results showed that plasma fibrinogen, smoking history, and SUVmax are predictors of high PD‐L1 expression, providing a basis for identifying patients expected to benefit from neoadjuvant ICI treatment.
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spelling doaj-art-01fa212b64f949ff8f69a1fbe25e8ccd2025-08-20T02:49:53ZengWileyThoracic Cancer1759-77061759-77142024-11-0115312229223410.1111/1759-7714.15453Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancerShuta Ohara0Kenichi Suda1Akira Hamada2Masato Chiba3Masaoki Ito4Masaki Shimoji5Toshiki Takemoto6Junichi Soh7Yasuhiro Tsutani8Division of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanDivision of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka‐Sayama JapanAbstract Background Superior outcomes have been obtained for neoadjuvant treatment with immune checkpoint inhibitors (ICI) plus chemotherapy over neoadjuvant chemotherapy alone, especially in patients with high programmed cell death ligand 1 (PD‐L1) expression. However, it is not always possible to obtain sufficient tumor specimens for biomarker testing before surgery. In this study, we explored clinical factors that can predict high PD‐L1 expression. Methods We retrospectively enrolled 340 lung cancer patients who received pulmonary resection between 2014 and 2023 and who had PD‐L1 expression data. Chi‐squared tests and logistic regression analyses were used to identify clinical factors associated with high PD‐L1 status. Results Univariable and multivariable analyses revealed that smoking, high maximum standardized uptake value (SUVmax) of 18F‐fluorodeoxyglucose positron emission computed tomography (18F‐FDG PET/CT), and high plasma fibrinogen are independent predictors of high PD‐L1 expression. A predictive score for high PD‐L1 expression (ranging from 0 to 3) was developed based on these parameters. Notably, only 5% of patients with a score of 0 exhibited high PD‐L1 expression, whereas this proportion increased to 53% for patients with a score of 3. Conclusion These results showed that plasma fibrinogen, smoking history, and SUVmax are predictors of high PD‐L1 expression, providing a basis for identifying patients expected to benefit from neoadjuvant ICI treatment.https://doi.org/10.1111/1759-7714.15453non‐small cell lung cancerplasma fibrinogenprogrammed cell death ligand 1SUVmax
spellingShingle Shuta Ohara
Kenichi Suda
Akira Hamada
Masato Chiba
Masaoki Ito
Masaki Shimoji
Toshiki Takemoto
Junichi Soh
Yasuhiro Tsutani
Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
Thoracic Cancer
non‐small cell lung cancer
plasma fibrinogen
programmed cell death ligand 1
SUVmax
title Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
title_full Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
title_fullStr Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
title_full_unstemmed Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
title_short Clinical factors associated with high PD‐L1 expression in patients with early‐stage non‐small cell lung cancer
title_sort clinical factors associated with high pd l1 expression in patients with early stage non small cell lung cancer
topic non‐small cell lung cancer
plasma fibrinogen
programmed cell death ligand 1
SUVmax
url https://doi.org/10.1111/1759-7714.15453
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