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▎ Clinical problems:
immunotherapy (IO) Many NSCLC patients do not benefit well
.
For some of these patients, combination chemotherapy (CT) can improve their prognosis
.
But the reliability of PD-L1 expression alone as the only biomarker that distinguishes these patients is not ideal
.
So, are there new clinical cases and molecular predictors that could be combined with PD-L1 to assist patients with NSCLC in therapy selection?
A study from J Natl Cancer Inst showed that in combination with PD-L1 expression, certain clinicopathological and molecular predictors can help patients with advanced non-small cell lung cancer NSCLC select the most appropriate IO-based first-line therapy
.
▎Research protocol:
A systematic search of randomized controlled trials (RCTs) of patients with advanced NSCLC who were treated for first time included 25 RCTs and 14,367 of them with advanced NSCLC, comparing IO or combined CT alone with CT alone
.
Meta-analysis and meta-regression analysis were used to investigate IO versus CT regimen, immunotherapy regimen (CIT) regimen with combination chemotherapy regimen versus CT regimen and IO regimen versus CIT regimen
.
▎Key findings:
(1) For males, current/previous smoking, PD-L1 expression ≥ 50% and patients with high tumor mutation burden (TMB), IO regimen was associated with improved survival compared with
CT regimen.
Conversely, in women, no smoking history, negative PD-L1 expression, and patients with low TMB, no satisfactory results were achieved with IO regimens compared with CT regimens, but no such association
was found between CIT regimens and CT regimens.
(2) For female patients, non-smokers, patients with PD-L1 expression ≥ 1% (but PD-L1 expression <50%) or low TMB, CIT regimen significantly improved patient survival compared with IO regimen<b20>.
▎Outlook:
These findings suggest certain clinicopathologic and molecular features (in combination with PD-L1 expression) that can help patients with advanced NSCLC select the most appropriate IO-based first-line therapy
.
References: [1]https://academic.
oup.
com/jnci/advance-article/doi/10.
1093/jnci/djac205/6794208
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: 1.
Scan the QR code below to jump "Top Essentials" H5 page
2 Download now"
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J Natl Cancer Inst: Certain clinicopathological and molecular predictors in combination with PD-L1 expression can help select the most appropriate IO-based first-line therapy for patients with advanced non-small cell lung cancer
▎ Clinical problems:
immunotherapy (IO) Many NSCLC patients do not benefit well
.
For some of these patients, combination chemotherapy (CT) can improve their prognosis
.
But the reliability of PD-L1 expression alone as the only biomarker that distinguishes these patients is not ideal
.
So, are there new clinical cases and molecular predictors that could be combined with PD-L1 to assist patients with NSCLC in therapy selection?
A study from J Natl Cancer Inst showed that in combination with PD-L1 expression, certain clinicopathological and molecular predictors can help patients with advanced non-small cell lung cancer NSCLC select the most appropriate IO-based first-line therapy
.
▎Research protocol:
A systematic search of randomized controlled trials (RCTs) of patients with advanced NSCLC who were treated for first time included 25 RCTs and 14,367 of them with advanced NSCLC, comparing IO or combined CT alone with CT alone
.
Meta-analysis and meta-regression analysis were used to investigate IO versus CT regimen, immunotherapy regimen (CIT) regimen with combination chemotherapy regimen versus CT regimen and IO regimen versus CIT regimen
.
▎Key findings:
(1) For males, current/previous smoking, PD-L1 expression ≥ 50% and patients with high tumor mutation burden (TMB), IO regimen was associated with improved survival compared with
CT regimen.
Conversely, in women, no smoking history, negative PD-L1 expression, and patients with low TMB, no satisfactory results were achieved with IO regimens compared with CT regimens, but no such association
was found between CIT regimens and CT regimens.
(2) For female patients, non-smokers, patients with PD-L1 expression ≥ 1% (but PD-L1 expression <50%) or low TMB, CIT regimen significantly improved patient survival compared with IO regimen<b20>.
▎Outlook:
These findings suggest certain clinicopathologic and molecular features (in combination with PD-L1 expression) that can help patients with advanced NSCLC select the most appropriate IO-based first-line therapy
.
References: [1]https://academic.
oup.
com/jnci/advance-article/doi/10.
1093/jnci/djac205/6794208
The top essential assistant of the clinical literature is online 👇
: 1.
Scan the QR code below to jump "Top Essentials" H5 page
2 Download now"
3.
Open the Doctor Station App and click on the column
4.
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