The correlation between programmed death-ligand 1 expression and driver gene mutations in NSCLC.

Area of Science:

• Oncology
• Immunotherapy
• Molecular Diagnostics

Background:

• Non-small cell lung cancer (NSCLC) treatment is evolving with targeted therapies and immunotherapies.
• Programmed death-ligand 1 (PD-L1) expression is a biomarker for immunotherapy response.
• Driver gene mutations are critical in NSCLC pathogenesis and treatment selection.

Purpose of the Study:

• To investigate the correlation between positive PD-L1 expression and driver gene mutations in NSCLC.
• To explore the potential of combining PD-L1 inhibitors with targeted agents for NSCLC treatment.

Main Methods:

• A systematic literature search was conducted across PubMed, EMBASE, and Cochrane Library databases.
• Data from 11 studies, including 3128 cases, were pooled and analyzed using Review Manager 5.3.
• Meta-analysis was employed to assess the relationships between PD-L1 expression, driver mutations, and clinical characteristics.

Main Results:

• Positive PD-L1 expression showed a significant association with KRAS mutation status (RR = 1.26).
• No significant correlation was found between PD-L1 expression and clinical factors (gender, smoking, histology) or EGFR/ALK mutations overall.
• Subgroup analyses revealed a significant correlation between PD-L1 expression and overall survival in Chinese cohorts and with KRAS/EGFR mutations when using specific PD-L1 monoclonal antibodies.

Conclusions:

• Positive PD-L1 expression is significantly associated with KRAS mutations in NSCLC.
• PD-L1 inhibitors represent a promising therapeutic option for advanced NSCLC patients with KRAS mutations.
• Combination therapy of PD-L1 inhibitors and targeted agents warrants further investigation.