Abstract
IntroductionPrevious studies have demonstrated that programmed cell death-ligand 1 (PD-L1) serves as biomarker for poor prognosis and survival in advanced-stage non-small cell lung cancer (NSCLC) patients. However, the merit of PD-L1 expression to predict the prognosis of early stage NSCLC patients who underwent complete resection remains controversial. In the present study, we performed a meta-analysis to investigate the relationship between PD-L1 expression and prognosis in patients with early stage resected NSCLC.MethodsElectronic databases, including PubMed, EMBASE, and the Cochrane Library, were searched until July 23 2020 for studies evaluating the expression of PD-L1 and the prognosis of resected NSCLCs. Hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) and disease-free survival (DFS) were pooled and analyzed. Heterogeneity and publication bias analyses were also assessed.ResultsA total of 15 studies involving 3,790 patients were considered in the present meta-analysis. The pooled HR indicated that PD-L1 expression related to a much shorter DFS (HR = 1.56, 95% CI: 1.18–2.05, p < 0.01), as well a significantly worse OS (HR = 1.68, 95% CI: 1.29–2.18, p < 0.01). Furthermore, our analysis indicated that PD-L1 expression was significantly associated with gender (male vs. female: OR = 1.27, 95% CI:1.01–1.59, p = 0.038), histology (ADC vs. SCC: OR = 0.54, 95% CI:0.38–0.77, p = 0.001), TNM stage (I vs. II–III: OR = 0.45, 95% CI:0.34–0.60, p = 0.000), smoking status (Yes vs No: OR = 1.43, 95% CI:1.14–1.80, p = 0.002) and lymph node metastasis (N+ vs N−: OR = 1.97, 95% CI:1.26–3.08, p = 0.003).ConclusionsThe results of this meta-analysis suggest that PD-L1 expression predicts an unfavorable prognosis in early stage resected NSCLCs. The role of personalized anti-PD-L1/PD-1 immunotherapy in the adjuvant settings of resected NSCLC warrants further investigation.
Highlights
Previous studies have demonstrated that programmed cell death-ligand 1 (PD-L1) serves as biomarker for poor prognosis and survival in advanced-stage non-small cell lung cancer (NSCLC) patients
Eligible studies were in agreement with the following criteria: [1] the histology type of cancer was NSCLC; [2] valid TNM stage and cancer differentiation, as well as sufficient survival data, such as hazard ratio (HR) with 95% confidence intervals (CI), overall survival (OS), and diseasefree survival (DFS) were available [3] were published in English; [4] evaluated the association between PD-L1 expression and prognosis or pathological features; [5] involved early stage resectable NSCLC patients; [6] had similar research experimental design and methods; [7] PD-L1 expression was divided into high and low categories; and [8] relevant information could be extracted from the full-text study
We found that PD-L1 expression at 5% cutoff value was not correlated to DFS (HR = 1.39, 95% CI: 0.89–2.17, p = 0.142) (Supplementary Data 4), but indicated a significantly worse OS (HR = 1.93, 95% CI: 1.57–2.36, p = 0.000) (Supplementary Data 5)
Summary
Previous studies have demonstrated that programmed cell death-ligand 1 (PD-L1) serves as biomarker for poor prognosis and survival in advanced-stage non-small cell lung cancer (NSCLC) patients. The merit of PD-L1 expression to predict the prognosis of early stage NSCLC patients who underwent complete resection remains controversial. Surgery is the standard treatment for early stage non-small cell lung cancer (NSCLC); postoperative prognosis remains unsatisfactory, with a 5-year survival rate ranging between 71 and 83% [2].it is essential to identify new biomarkers for efficient clinical decision making and improve patient outcomes. Blockade of the programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) signaling pathway is one of the most promising immunotherapeutic strategies in boosting the immune system in the fight against cancer [3, 4]. Blockade of the PD-1/PD-L1 pathway with monoclonal antibodies is a promising therapeutic strategy, with prominent clinical benefits of this checkpointblockade observed in recent clinical trials [7, 8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
