First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis
ObjectiveTo evaluate the optimal first-line treatment options for programmed death-ligand 1 (PD-L1) negative lung adenocarcinoma (LUAD) patients without common gene-alterations.MethodsA total of 159 PD-L1-negative LUAD patients without common gene-alterations were included. Chemotherapy was administ...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1533048/full |
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| author | Lijuan Chen Lijuan Chen Jie Liu Jie Liu Junfeng Lu Junfeng Lu Xiufeng Hu Xiufeng Hu Erjing An Erjing An Yanqiu Zhao Yanqiu Zhao |
| author_facet | Lijuan Chen Lijuan Chen Jie Liu Jie Liu Junfeng Lu Junfeng Lu Xiufeng Hu Xiufeng Hu Erjing An Erjing An Yanqiu Zhao Yanqiu Zhao |
| author_sort | Lijuan Chen |
| collection | DOAJ |
| description | ObjectiveTo evaluate the optimal first-line treatment options for programmed death-ligand 1 (PD-L1) negative lung adenocarcinoma (LUAD) patients without common gene-alterations.MethodsA total of 159 PD-L1-negative LUAD patients without common gene-alterations were included. Chemotherapy was administered in 44 cases (group A), immunotherapy-chemotherapy combinations in 55 cases (group B) and bevacizumab plus chemotherapy in 60 patients (group C). A head-to-head comparison of the clinical effectiveness and safety for these standard treatment regimens was conducted.ResultsThe median follow-up time was 30.9 months. For the entire cohort, median PFS was 6.67 months [95% CI 5.83-7.51], and median OS was 15.83 months [95% CI 13.46-18.21]. OS was significantly longer in group C versus others (C vs B median 21.6 months [95% CI 17.78-25.42] vs 12.63 months [95% CI 8.14-17.13]; HR 0.59 [95% CI 0.39-0.9], P = 0.01; C vs A median 21.6 months [95% CI 17.78-25.42] vs 13.47 months [95% CI 9.68-17.26], HR 0.47 [95% CI 0.3-0.71], P= 0.001), but no substantial difference was noted between group A and B (HR 0.78 [95% CI 0.51-1.2], P= 0.26). For PFS in pairwise comparison, group B and C were statistically superior to group A (B vs A median 5.6 months [95% CI 4.56-6.64] vs 5.17 months [95% CI 4.09-6.25]; hazard ratio (HR) 0.56 [95% CI 0.37-0.87], P = 0.009; C vs A median 8.57 months [95% CI 7.47-9.66] vs 5.17 months [95% CI 4.09-6.25]; HR 0.43 [95% CI 0.28-0.7], P< 0.001), whereas no significant difference was found between group B and C (HR 0.76 [95% CI 0.51-1.11], P= 0.16). The disease control rate (DCR) improvement was sustained with group C (A vs B vs C: 84.09% vs 83.64% vs 96.67%, respectively (P<0.05)). Multivariate analysis showed that the performance status score and treatment regimen were factors influencing PFS as well as OS. The treatment-emergent adverse events (AEs) of grade 3–4 occurred in a similar proportion of patients in each group (P>0.05), and all AEs were manageable without fatal toxicities.ConclusionsBevacizumab plus chemotherapy should be prioritized in PD-L1-negative LUAD patients without common driver gene alterations. These findings may facilitate individualized treatment options. |
| format | Article |
| id | doaj-art-bf5221a0a2a74ca1b9acc05e1e081d6a |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-bf5221a0a2a74ca1b9acc05e1e081d6a2025-08-20T03:07:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15330481533048First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysisLijuan Chen0Lijuan Chen1Jie Liu2Jie Liu3Junfeng Lu4Junfeng Lu5Xiufeng Hu6Xiufeng Hu7Erjing An8Erjing An9Yanqiu Zhao10Yanqiu Zhao11Department of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaDepartment of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaDepartment of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaDepartment of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaDepartment of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaDepartment of Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaHenan International Joint Laboratory of Lung Cancer Biology and Therapeutics, Zhengzhou, ChinaObjectiveTo evaluate the optimal first-line treatment options for programmed death-ligand 1 (PD-L1) negative lung adenocarcinoma (LUAD) patients without common gene-alterations.MethodsA total of 159 PD-L1-negative LUAD patients without common gene-alterations were included. Chemotherapy was administered in 44 cases (group A), immunotherapy-chemotherapy combinations in 55 cases (group B) and bevacizumab plus chemotherapy in 60 patients (group C). A head-to-head comparison of the clinical effectiveness and safety for these standard treatment regimens was conducted.ResultsThe median follow-up time was 30.9 months. For the entire cohort, median PFS was 6.67 months [95% CI 5.83-7.51], and median OS was 15.83 months [95% CI 13.46-18.21]. OS was significantly longer in group C versus others (C vs B median 21.6 months [95% CI 17.78-25.42] vs 12.63 months [95% CI 8.14-17.13]; HR 0.59 [95% CI 0.39-0.9], P = 0.01; C vs A median 21.6 months [95% CI 17.78-25.42] vs 13.47 months [95% CI 9.68-17.26], HR 0.47 [95% CI 0.3-0.71], P= 0.001), but no substantial difference was noted between group A and B (HR 0.78 [95% CI 0.51-1.2], P= 0.26). For PFS in pairwise comparison, group B and C were statistically superior to group A (B vs A median 5.6 months [95% CI 4.56-6.64] vs 5.17 months [95% CI 4.09-6.25]; hazard ratio (HR) 0.56 [95% CI 0.37-0.87], P = 0.009; C vs A median 8.57 months [95% CI 7.47-9.66] vs 5.17 months [95% CI 4.09-6.25]; HR 0.43 [95% CI 0.28-0.7], P< 0.001), whereas no significant difference was found between group B and C (HR 0.76 [95% CI 0.51-1.11], P= 0.16). The disease control rate (DCR) improvement was sustained with group C (A vs B vs C: 84.09% vs 83.64% vs 96.67%, respectively (P<0.05)). Multivariate analysis showed that the performance status score and treatment regimen were factors influencing PFS as well as OS. The treatment-emergent adverse events (AEs) of grade 3–4 occurred in a similar proportion of patients in each group (P>0.05), and all AEs were manageable without fatal toxicities.ConclusionsBevacizumab plus chemotherapy should be prioritized in PD-L1-negative LUAD patients without common driver gene alterations. These findings may facilitate individualized treatment options.https://www.frontiersin.org/articles/10.3389/fonc.2025.1533048/fulllung adenocarcinomaPD-L1 negativefirst-line treatmentbevacizumabimmunotherapyprognosis |
| spellingShingle | Lijuan Chen Lijuan Chen Jie Liu Jie Liu Junfeng Lu Junfeng Lu Xiufeng Hu Xiufeng Hu Erjing An Erjing An Yanqiu Zhao Yanqiu Zhao First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis Frontiers in Oncology lung adenocarcinoma PD-L1 negative first-line treatment bevacizumab immunotherapy prognosis |
| title | First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis |
| title_full | First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis |
| title_fullStr | First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis |
| title_full_unstemmed | First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis |
| title_short | First-line treatment options for PD-L1-negative lung adenocarcinoma: a real-world analysis |
| title_sort | first line treatment options for pd l1 negative lung adenocarcinoma a real world analysis |
| topic | lung adenocarcinoma PD-L1 negative first-line treatment bevacizumab immunotherapy prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1533048/full |
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