The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis
Abstract Background: The use of immune checkpoint inhibitors (ICIs) as neoadjuvant therapy is a promising novel approach in resectable non-small-cell lung cancer (NSCLC). This study aimed to investigate the prognostic value of PD-L1 in patients with NSCLC receiving neoadjuvant immune checkpoint inhi...
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Nature Portfolio
2024-10-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-78159-y |
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| author | Dun-Chang Mo Jian-Feng Huang Peng Lin Shang-Xiao Huang Han-Lei Wang Peng-Hui Luo Xiu-Juan Liang |
| author_facet | Dun-Chang Mo Jian-Feng Huang Peng Lin Shang-Xiao Huang Han-Lei Wang Peng-Hui Luo Xiu-Juan Liang |
| author_sort | Dun-Chang Mo |
| collection | DOAJ |
| description | Abstract Background: The use of immune checkpoint inhibitors (ICIs) as neoadjuvant therapy is a promising novel approach in resectable non-small-cell lung cancer (NSCLC). This study aimed to investigate the prognostic value of PD-L1 in patients with NSCLC receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy (CT). Materials and methods: Several databases (PubMed, Embase, and cochrane central register of controlled trials [CENTRAL]) were systematically searched. Randomized controlled trials (RCTs) investigating pathological and survival outcomes with neoadjuvant ICI + CT versus CT alone in NSCLC were analyzed. Results: Overall, eight RCTs (n = 3,404) were included. The analyses showed neoadjuvant ICI + CT significantly improved complete pathological response (pCR) and event-free survival (EFS) in either tumor PD-L1 < 1%, ≥ 1%, 1-49%, or ≥ 50% population (both p < 0.0001) compared with neoadjuvant CT alone. The overall survival (OS) data are not yet mature among all included RCTs, and only three RCTs presented OS data by PD-L1 status of patients. The pooled OS favored neoadjuvant ICI + CT in the PD-L1 ≥ 1% population (hazard ratio [HR], 0.45; 95% CI, 0.31–0.65; p < 0.0001), but not in the PD-L1 < 1% population (HR, 0.89; 95% CI, 0.66–1.19; p = 0.43). Conclusions: Compared with neoadjuvant CT alone, neoadjuvant ICI + CT significantly enhanced pCR and EFS for patients with resectable NSCLC regardless of the expression of PD-L1. It seems that only patients with PD-L1 positive tumors may achieve a better OS, but it’s currently inconclusive due to immature data, so future research with long-term follow-up is still needed. |
| format | Article |
| id | doaj-art-b8856f97a7b04cef84e5866486c8acbc |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-b8856f97a7b04cef84e5866486c8acbc2025-08-20T02:18:28ZengNature PortfolioScientific Reports2045-23222024-10-0114111110.1038/s41598-024-78159-yThe role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysisDun-Chang Mo0Jian-Feng Huang1Peng Lin2Shang-Xiao Huang3Han-Lei Wang4Peng-Hui Luo5Xiu-Juan Liang6Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityRadiotherapy Department, The Third Affiliated Hospital of Guangxi Medical UniversityAbstract Background: The use of immune checkpoint inhibitors (ICIs) as neoadjuvant therapy is a promising novel approach in resectable non-small-cell lung cancer (NSCLC). This study aimed to investigate the prognostic value of PD-L1 in patients with NSCLC receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy (CT). Materials and methods: Several databases (PubMed, Embase, and cochrane central register of controlled trials [CENTRAL]) were systematically searched. Randomized controlled trials (RCTs) investigating pathological and survival outcomes with neoadjuvant ICI + CT versus CT alone in NSCLC were analyzed. Results: Overall, eight RCTs (n = 3,404) were included. The analyses showed neoadjuvant ICI + CT significantly improved complete pathological response (pCR) and event-free survival (EFS) in either tumor PD-L1 < 1%, ≥ 1%, 1-49%, or ≥ 50% population (both p < 0.0001) compared with neoadjuvant CT alone. The overall survival (OS) data are not yet mature among all included RCTs, and only three RCTs presented OS data by PD-L1 status of patients. The pooled OS favored neoadjuvant ICI + CT in the PD-L1 ≥ 1% population (hazard ratio [HR], 0.45; 95% CI, 0.31–0.65; p < 0.0001), but not in the PD-L1 < 1% population (HR, 0.89; 95% CI, 0.66–1.19; p = 0.43). Conclusions: Compared with neoadjuvant CT alone, neoadjuvant ICI + CT significantly enhanced pCR and EFS for patients with resectable NSCLC regardless of the expression of PD-L1. It seems that only patients with PD-L1 positive tumors may achieve a better OS, but it’s currently inconclusive due to immature data, so future research with long-term follow-up is still needed.https://doi.org/10.1038/s41598-024-78159-yPD-L1Immune checkpoint inhibitorComplete pathological responseEvent-free survivalOverall survivalNon-small cell lung cancer |
| spellingShingle | Dun-Chang Mo Jian-Feng Huang Peng Lin Shang-Xiao Huang Han-Lei Wang Peng-Hui Luo Xiu-Juan Liang The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis Scientific Reports PD-L1 Immune checkpoint inhibitor Complete pathological response Event-free survival Overall survival Non-small cell lung cancer |
| title | The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis |
| title_full | The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis |
| title_fullStr | The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis |
| title_full_unstemmed | The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis |
| title_short | The role of PD-L1 in patients with non-small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy: a meta-analysis |
| title_sort | role of pd l1 in patients with non small cell lung cancer receiving neoadjuvant immune checkpoint inhibitor plus chemotherapy a meta analysis |
| topic | PD-L1 Immune checkpoint inhibitor Complete pathological response Event-free survival Overall survival Non-small cell lung cancer |
| url | https://doi.org/10.1038/s41598-024-78159-y |
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