PD-L1 Expression in Circulating Tumor Cells as a Promising Prognostic Biomarker in Advanced Non–small-cell Lung Cancer Treated with Immune Checkpoint Inhibitors

Circulating tumor cells (CTCs) are a promising source of biological information in cancer. Data correlating PD-L1 expression in CTCs with patients’ response to immune checkpoint inhibitors (ICIs) in non–small-cell lung cancer (NSCLC) are still lacking. This is a prospective single-center cohort stud...

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Veröffentlicht in:Clinical lung cancer 2021-09, Vol.22 (5), p.423-431
Hauptverfasser: Dall'Olio, Filippo G., Gelsomino, Francesco, Conci, Nicole, Marcolin, Laura, De Giglio, Andrea, Grilli, Giada, Sperandi, Francesca, Fontana, Francesca, Terracciano, Mario, Fragomeno, Benedetta, Tober, Nastassja, Manferrari, Giulia, Brocchi, Stefano, Golfieri, Rita, Fiorentino, Michelangelo, Ardizzoni, Andrea
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Sprache:eng
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Zusammenfassung:Circulating tumor cells (CTCs) are a promising source of biological information in cancer. Data correlating PD-L1 expression in CTCs with patients’ response to immune checkpoint inhibitors (ICIs) in non–small-cell lung cancer (NSCLC) are still lacking. This is a prospective single-center cohort study enrolling patients with advanced NSCLC. CTCs were identified and counted with the CellSearch system. PD-L1 expression on CTCs was assessed with phycoerythrin-conjugated anti-human PD-L1 antibody, clone MIH3 (BioLegend, USA). Primary endpoint was the correlation between the CTCs PD-L1 expression and overall survival (OS). Among secondary objectives, we evaluated the correlation between PD-L1 expression on CTCs and matched tumor tissue and the correlation of CTC number and baseline tumor size (BTS). Thirty-nine patients treated with anti-PD-1/PD-L1 agents as second- or third-line therapy were enrolled. Patients were divided into 3 groups: no CTC detectable (CTCnull, n = 15), PD-L1 positive CTC (CTCpos, n = 13), and PD-L1 negative CTC (CTCneg, n = 11). Median OS in patients with CTCneg was 2.2 months, 95% confidence interval (CI), 0.8-3.6 (reference) versus 3.7 months, 95% CI, 0.1-7.5 (hazard ratio [HR] 0.33; 95% CI, 0.13-0.83; P = .019) in patients with CTCpos versus 16.0 months, 95% CI, 2.2-29.8 (HR 0.17; 95% CI, 0.06-0.45; P< .001) in patients with CTCnull. No correlation was found between PD-L1 expression on CTCs and on tumor tissue. CTC number was correlated with BTS. PD-L1 expression on CTCs is a promising biomarker in patients with NSCLC treated with ICIs. Further validation as predictive biomarker is needed. Biomarkers for immunotherapy represent a clinical need. Circulating tumor cells (CTCs) are associated with a worse outcome. This is a prospective single-center cohort study enrolling 39 patients with non–small-cell lung cancer. A median overall survival of 2.2, 3.7, and 16 months was observed in patients with negative CTC, positive CTC, and no CTC detectable, respectively. No correlation was found between PD-L1 expression on CTCs and on tumor tissue. CTCs were correlated with baseline tumor size. PD-L1 on CTCs is a promising biomarker.
ISSN:1525-7304
1938-0690
DOI:10.1016/j.cllc.2021.03.005