Baseline PD-L1 expression on circulating immune cells as a predictor of survival and immune-related adverse events in extensive-stage small-cell lung cancer patients treated with durvalumab and carboplatin-etoposide (NCT04712903 Trial)

Introduction: Despite improved efficacy with first-line immune checkpoint inhibitors plus platinum250 based chemotherapy for extensive-stage small cell lung cancer (ES-SCLC), long-term survival remains limited. There is currently no available predictive biomarker to identify which patients would ben...

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Autores: Piedra, Aida|||0000-0002-4795-1132, Guinart Cuadra, Albert|||0000-0003-0233-5595, Martínez-Recio, Sergio|||0000-0001-8056-7100, Mulet Gual, Maria|||0000-0003-3639-3291, Zamora, Carlos|||0000-0003-2962-678X, Osuna Gómez, Rubén|||0000-0003-2875-4405, Cantó, Elisabet|||0000-0002-1782-1855, Ortiz, M. Àngels|||0000-0002-1574-9861, Alejandre, Jose, Barba Joaquin, Andrés|||0000-0003-2500-0253, Sanz-Beltran, Judit|||0000-0001-7526-4973, Serra, Jorgina|||0000-0002-2363-7149, Isla, Dolores|||0000-0002-2483-198X, Arriola, Edurne|||0000-0001-8960-7519, Paz-Ares, Luis|||0000-0002-3327-3246, Diz Taín, Pilar|||0000-0003-4284-3965, Moreno Vega, Alberto Luis|||0000-0002-4063-7773, Callejo, A., Vidal, Silvia|||0000-0002-3909-6682, Majem Tarruella, Margarita|||0000-0002-9919-7485
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:326041
Acceso en línea:https://ddd.uab.cat/record/326041
Access Level:acceso abierto
Palabra clave:Predictive biomarker
Extensive stage small-cell lung cancer (ES-SCLC)
Circulating immune cells
Circulating PD-L1+ monocytes
circulating PD-L1+ 283 neutrophils
Immunotherapy
Descripción
Sumario:Introduction: Despite improved efficacy with first-line immune checkpoint inhibitors plus platinum250 based chemotherapy for extensive-stage small cell lung cancer (ES-SCLC), long-term survival remains limited. There is currently no available predictive biomarker to identify which patients would benefit most from this treatment. We hypothesized that pre253 treatment PD-L1 expression on circulating immune cells might predict survival outcomes and toxicity. Material and methods: This prospective, multi-center observational study included patients with untreated ES257 SCLC treated with first-line durvalumab plus platinum-based chemotherapy. The percentages of circulating PD-L1+ immune cells at baseline were analysed by flow cytometry to assess their association with survival outcomes and the development of immune-related adverse events (irAEs). Results: Among 41 patients with ES-SCLC, 65.9% were male, 73.2% had an ECOG-PS 1, 9.8% had central nervous system (CNS) metastases and 31.7% had liver metastases. Sixteen patients (39%) experienced irAEs. Median PFS was longer in patients with high percentages of circulating PD-L1 265 + monocytes compared to those with low percentages: 266 8.97 months (95% CI NR to NR) vs. 5.97 months (95% CI 4.65 to 7.28), p=0.007. There was a trend toward longer median OS in patients with ES-SCLC and high percentages of circulating PD-L1 268 + monocytes versus low percentages: NR (95% CI NR-NR) vs. 9.13 months (95% CI 6.34 to 11.92), p=0.092. Patients with higher circulating PD-L1+ neutrophils correlated with the development of irAES (p=0.007). Conclusions: Our results showed a statistically significant longer PFS in patients with ES-SCLC and high percentages of circulating PD-L1 274 + monocytes. This suggests PD-L1 expression on monocytes might be established as a predictive biomarker for patients with ES-SCLC treated with upfront chemo-immunotherapy.

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