Impact of PD-L1 expression on the efficacy of first-line crizotinib in advanced ROS1-rearranged NSCLC

•The predictive accuracy of PD-L1 expression in NSCLC patients with oncogenic drivers, such as those receiving TKI treatment, remains controversial.•We analyzed the correlation between PD-L1 expression and the efficacy of first-line crizotinib treatment in patients with ROS1-rearranged advanced NSCLC.•We found that patients with ROS1-rearranged advanced NSCLC can benefit from first-line crizotinib treatment regardless of PD-L1 expression. The predictive value of programmed death-ligand 1 (PD-L1) expression for the efficacy of tyrosine kinase inhibitors (TKIs) in patients with advanced ROS1-rearranged non-small cell lung cancer (NSCLC) remains underexplored. This study analyzed patients with advanced NSCLC harboring ROS1 rearrangements who received first-line crizotinib to evaluate the correlation between baseline PD-L1 expression and crizotinib efficacy. In this study, the clinical data from 371 patients diagnosed with ROS1-rearranged NSCLC at Shanghai Chest Hospital between November 2017 and December 2022 were reviewed. The patients were categorized into three groups according to the baseline PD-L1 expression: tumor proportion score (TPS)