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...

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Autores: Piedra, A, Guinart-Cuadra, A, Martínez-Recio, S, Mulet, M, Zamora, C, Osuna-Gómez, R, Cantó, E, Ortiz, MA, Alejandre, J, Barba, A, Sanz-Beltrán, J, Serra-López, J, Isla, D, Arriola, E, Paz-Ares, L, Diz-Taín, MP, Moreno, AL, Callejo, A, Vidal, S, Majem, M
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
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spelling 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)Piedra, AGuinart-Cuadra, AMartínez-Recio, SMulet, MZamora, COsuna-Gómez, RCantó, EOrtiz, MAAlejandre, JBarba, ASanz-Beltrán, JSerra-López, JIsla, DArriola, EPaz-Ares, LDiz-Taín, MPMoreno, ALCallejo, AVidal, SMajem, MPredictive biomarkerExtensive stage small-cell lung cancer (ES-SCLC)Circulating immune cellsCirculating PD-L1(+) monocytesCirculating PD-L1(+) neutrophilsImmunotherapyIntroduction 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.BIOMED CENTRAL LTD2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21288Journal of Translational MedicineISSN: 14795876reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:dnet:r-iibsantpa_::e551b198264120f5ae6bd00268e1c9622026-06-14T12:41:47Z
dc.title.none.fl_str_mv 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)
title 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)
spellingShingle 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)
Piedra, A
Predictive biomarker
Extensive stage small-cell lung cancer (ES-SCLC)
Circulating immune cells
Circulating PD-L1(+) monocytes
Circulating PD-L1(+) neutrophils
Immunotherapy
title_short 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)
title_full 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)
title_fullStr 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)
title_full_unstemmed 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)
title_sort 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)
dc.creator.none.fl_str_mv Piedra, A
Guinart-Cuadra, A
Martínez-Recio, S
Mulet, M
Zamora, C
Osuna-Gómez, R
Cantó, E
Ortiz, MA
Alejandre, J
Barba, A
Sanz-Beltrán, J
Serra-López, J
Isla, D
Arriola, E
Paz-Ares, L
Diz-Taín, MP
Moreno, AL
Callejo, A
Vidal, S
Majem, M
author Piedra, A
author_facet Piedra, A
Guinart-Cuadra, A
Martínez-Recio, S
Mulet, M
Zamora, C
Osuna-Gómez, R
Cantó, E
Ortiz, MA
Alejandre, J
Barba, A
Sanz-Beltrán, J
Serra-López, J
Isla, D
Arriola, E
Paz-Ares, L
Diz-Taín, MP
Moreno, AL
Callejo, A
Vidal, S
Majem, M
author_role author
author2 Guinart-Cuadra, A
Martínez-Recio, S
Mulet, M
Zamora, C
Osuna-Gómez, R
Cantó, E
Ortiz, MA
Alejandre, J
Barba, A
Sanz-Beltrán, J
Serra-López, J
Isla, D
Arriola, E
Paz-Ares, L
Diz-Taín, MP
Moreno, AL
Callejo, A
Vidal, S
Majem, M
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Predictive biomarker
Extensive stage small-cell lung cancer (ES-SCLC)
Circulating immune cells
Circulating PD-L1(+) monocytes
Circulating PD-L1(+) neutrophils
Immunotherapy
topic Predictive biomarker
Extensive stage small-cell lung cancer (ES-SCLC)
Circulating immune cells
Circulating PD-L1(+) monocytes
Circulating PD-L1(+) neutrophils
Immunotherapy
description 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.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21288
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21288
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BIOMED CENTRAL LTD
publisher.none.fl_str_mv BIOMED CENTRAL LTD
dc.source.none.fl_str_mv Journal of Translational Medicine
ISSN: 14795876
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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