■免疫检查点抑制剂(ICIs)对非小细胞肺癌(NSCLC)治疗有效,但反应率仍然很低。外周血中的程序性细胞死亡配体1(PD-L1),包括可溶形式(sPD-L1),在循环肿瘤细胞(CTCsPD-L1)和外泌体(exoPD-L1)上的表达,是患者选择和管理的微创和有前途的标志,但其预后意义仍无定论.这里,我们对PD-L1血液标志物在接受ICIs治疗的NSCLC患者中的预后价值进行了荟萃分析.
■通过搜索PubMed,EMBAS,WebofScience,和Cochrane图书馆在2023年11月30日之前。预处理之间的关联,通过估计风险比(HR)和95%置信区间(CI)分析治疗后血液PD-L1水平和无进展生存期(PFS)/超生存期(OS)的动态变化.
■共纳入26项研究,包括1606名患者。治疗前或治疗后sPD-L1水平高与PFS差(治疗前:HR=1.49,95CI1.13-1.95;治疗后:HR=2.09,95CI1.40-3.12)和OS(治疗前:HR=1.83,95CI1.25-2.67;治疗后:HR=2.60,95CI1.09-6.20,P=0.032)显著相关。高治疗前exoPD-L1水平预测PFS更差(HR=4.24,95CI2.82-6.38,P<0.001)。治疗前PD-L1+CTC与延长的PFS(HR=0.63,95CI0.39-1.02)和OS(HR=0.58,95CI0.36-0.93)有相关性。exoPD-L1水平上调的患者,而非sPD-L1,ICIs治疗后的PFS(HR=0.36,95CI0.23-0.55)和OS(HR=0.24,95CI0.08-0.68)显著良好。
■PD-L1血液标志物,包括sPD-L1、CTCsPD-L1和exoPD-L1,并可能用于接受ICIs的NSCLC患者的患者选择和治疗管理。
UNASSIGNED: Immune checkpoint inhibitors (ICIs) are effective for non-small cell lung cancer (NSCLC) treatment, but the response rate remains low. Programmed cell death ligand 1 (PD-L1) in peripheral blood, including soluble form (sPD-L1), expression on circulating tumor cells (CTCs PD-L1) and exosomes (exoPD-L1), are minimally invasive and promising markers for patient selection and management, but their prognostic significance remains inconclusive. Here, we performed a meta-analysis for the prognostic value of PD-L1 blood markers in NSCLC patients treated with ICIs.
UNASSIGNED: Eligible studies were obtained by searching PubMed, EMBAS, Web of Science, and Cochrane Library prior to November 30, 2023. The associations between pre-treatment, post-treatment and dynamic changes of blood PD-L1 levels and progression-free survival (PFS)/over survival (OS) were analyzed by estimating hazard ratio (HR) and 95% confidence interval (CI).
UNASSIGNED: A total of 26 studies comprising 1606 patients were included. High pre- or post-treatment sPD-L1 levels were significantly associated with worse PFS (pre-treatment: HR=1.49, 95%CI 1.13-1.95; post-treatment: HR=2.09, 95%CI 1.40-3.12) and OS (pre-treatment: HR=1.83, 95%CI 1.25-2.67; post-treatment: HR=2.60, 95%CI 1.09-6.20, P=0.032). High pre-treatment exoPD-L1 levels predicted a worse PFS (HR=4.24, 95%CI 2.82-6.38, P<0.001). Pre-treatment PD-L1+ CTCs tended to be correlated with prolonged PFS (HR=0.63, 95%CI 0.39-1.02) and OS (HR=0.58, 95%CI 0.36-0.93). Patients with up-regulated exoPD-L1 levels, but not sPD-L1, after ICIs treatment had significantly favorable PFS (HR=0.36, 95%CI 0.23-0.55) and OS (HR=0.24, 95%CI 0.08-0.68).
UNASSIGNED: PD-L1 blood markers, including sPD-L1, CTCs PD-L1 and exoPD-L1, can effectively predict prognosis, and may be potentially utilized for patient selection and treatment management for NSCLC patients receiving ICIs.