Meta-analysis of circulating tumor cell PD-L1 expression and the association with clinical outcomes in non-small cell lung cancer
Document Type
Journal Article
Publication Title
Clinical Chemistry
Volume
70
Issue
1
First Page
234
Last Page
249
PubMed ID
38175603
Publisher
Oxford Academic
School
Centre for Precision Health / School of Medical and Health Sciences
RAS ID
62562
Funders
Cancer Coucil of Western Australia / Cancer Research UK
Abstract
Background: Programmed death ligand-1 (PD-L1) expression on circulating tumor cells (CTCs) has been suggested to provide prognostic information in non-small cell lung cancer (NSCLC), but consensus relative to treatment outcomes is lacking. We conducted the first comprehensive meta-analysis exploring its potential as a prognostic and predictive marker, and assessed the concordance between PD-L1 + CTCs and paired tumor tissue in NSCLC patients. Method: A comprehensive search was applied to PubMed and EMBASE to identify 26 studies that evaluated PD-L1 + CTCs and their association with survival outcomes in 1236 NSCLC patients. Results: The meta-analysis estimated a mean PD-L1 + CTCs detection rate of 61% (95% CI, 49-72). Subgroup analysis based on treatment showed that PD-L1 + CTCs was not significantly associated with better overall survival (OS) in NSCLC patients treated with immune checkpoint inhibitors (ICIs) (Hazard Ratio (HR) = 0.96, 95% CI, 0.35-2.65, P = 0.944), but was predictive of worse OS in those treated with other therapies (HR = 2.11, 95% CI, 1.32-3.36, P = 0.002). Similarly, PD-L1 + CTCs was not significantly associated with superior progressing free survival (PFS) in NSCLCs treated with ICIs (HR = 0.67, 95% CI, 0.41-1.09, P = 0.121), but was significantly associated with shorter PFS in patients treated with other therapies (HR = 1.91, 95% CI, 1.24-2.94, P = 0.001). The overall estimate for the concordance between PD-L1 expression on CTCs and tumor cells was 63% (95% CI, 44-80). Conclusion: The average detection rate of PD-L1 + CTCs was comparable to the rate of PD-L1 expression in NSCLC tumors. There was a trend towards better PFS in ICI-treated NSCLC patients with PD-L1 + CTCs. Larger longitudinal studies on the association of PD-L1 + CTCs with clinical outcomes in NSCLC patients treated with ICIs are warranted.
DOI
10.1093/clinchem/hvad187
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Comments
Acheampong, E., Allsopp, R. C., Page, K., Wadsley, M. K., Beasley, A. B., Coombes, R. C. . . . Gray. E. S. (2024). Meta-analysis of circulating tumor cell PD-L1 expression and the association with clinical outcomes in non-small cell lung cancer. Clinical Chemistry, 70(1), 234-249. https://doi.org/10.1093/clinchem/hvad187