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Association of PD-L1 expression and clinical outcomes in ROS1 - rearranged advanced non-small cell lung cancer treated with crizotinib

  • 0Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Frontiers in Oncology +

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June 5, 2024

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June 5, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Programmed cell death ligand 1 (PD-L1) expression may predict shorter progression-free survival in ROS1-rearranged non-small cell lung cancer (NSCLC) treated with crizotinib. However, PD-L1 status did not significantly impact overall survival in these patients.

Area Of Science

  • Oncology
  • Molecular Biology
  • Clinical Research

Background

  • Programmed cell death ligand 1 (PD-L1) expression is higher in ROS1-rearranged non-small cell lung cancer (NSCLC) than in NSCLC without driver mutations.
  • PD-L1 expression is linked to reduced efficacy of EGFR/ALK inhibitors in respective NSCLC subtypes.
  • The prognostic role of PD-L1 in first-line crizotinib therapy for ROS1-rearranged NSCLC remains unclear.

Purpose Of The Study

  • To investigate the relationship between PD-L1 expression levels and clinical outcomes in advanced ROS1-rearranged NSCLC patients.
  • To evaluate the impact of PD-L1 status on objective response rate (ORR), progression-free survival (PFS), disease control rate (DCR), and overall survival (OS).
  • To determine if PD-L1 expression serves as a prognostic marker for crizotinib treatment in this patient population.

Main Methods

  • Retrospective analysis of 246 ROS1-positive NSCLC patients diagnosed between January 2016 and December 2021.
  • Selection of 82 patients with advanced ROS1-rearranged NSCLC treated with first-line crizotinib.
  • Assessment of PD-L1 expression (positive/negative, high/low) and correlation with clinical endpoints (ORR, PFS, DCR, OS).

Main Results

  • Among 82 patients, 38 had PD-L1 positive tumors (11 high, 27 low) and 44 were PD-L1 negative.
  • Overall ORR was 80.5% with no significant difference across PD-L1 expression groups.
  • Median PFS was significantly shorter in PD-L1 negative vs. positive groups (26.4 vs. 13.7-16.6 months, p=0.001), and DCR differed between PD-L1 negative and high expression groups (100% vs. 90.9%, p=0.04).
  • Median OS was 53.0 months overall, with no significant difference between PD-L1 negative and positive groups (57.2 vs. 53.0 months, p=0.43).

Conclusions

  • PD-L1 expression appears to be a negative prognostic marker for progression-free survival (PFS) in ROS1-positive NSCLC patients receiving first-line crizotinib.
  • PD-L1 status did not significantly affect overall survival (OS) in this cohort.
  • Further research may clarify the precise role of PD-L1 in guiding treatment decisions for ROS1-rearranged NSCLC.

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