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 platinum-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...
| Autores: | , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2026 |
| País: | España |
| Institución: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositorio: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:dnet:r-iibsantpa_::e551b198264120f5ae6bd00268e1c962 |
| Acceso en línea: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21288 |
| 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(+) neutrophils Immunotherapy |
| Sumario: | Introduction Despite improved efficacy with first-line immune checkpoint inhibitors plus platinum-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 pre-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 ES-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(+) monocytes compared to those with low percentages: 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(+) 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(+) 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. Trial registration NCT04712903 Trial. Last registered 1 December 2025, https://www.clinicaltrials.gov/study/NCT04712903. |
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