Prognostic Role of Soluble Programmed Death Ligand 1 in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Abstract

ObjectiveThe objective of this study was to explore whether soluble programmed death ligand 1 (sPD-L1) is a potential prognostic biomarker in patients with non-small cell lung cancer (NSCLC).MethodsA comprehensive search of electronic databases was carried out. Original studies with inclusion of sPD-L1, progression-free survival, and overall survival in NSCLC were eligible. The primary endpoints were overall survival and progression-free survival. Hazard ratios (HRs) and 95% confidence intervals (CIs) were applied for data analysis.ResultsEight studies involving 710 patients with NSCLC were included in the analysis. A pooled data analysis revealed that high levels of sPD-L1 were correlated with poorer overall survival (HR = 2.34; 95% CI = 1.82–3.00; P < 0.001) and progression-free survival (HR = 2.35; 95% CI = 1.62–3.40, P < 0.001). A subgroup analysis revealed that high levels of sPD-L1 were correlated with poor overall survival in patients treated with immunotherapy (HR = 2.40; 95% CI = 1.79–3.22; P < 0.001).ConclusionThis pooled analysis of published data suggests that sPD-L1 may serve as a readily available biomarker for survival in NSCLC patients treated with ICI based treatment. Prospective studies with well-designed standard assessment methods should be conducted to validate the prognostic role of sPD-L1 in NSCLC.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283177.

Reshaping the systemic tumor immune environment (STIE) and tumor immune microenvironment (TIME) to enhance immunotherapy efficacy in solid tumors

“…Finkelmeier et al [73] also found that plasma sPD-L1 levels were positively correlated with liver cirrhosis and cancer stage related in HCC patients who were exposed to PD-1 inhibitor immunotherapy. Indeed, our recent meta-analysis of 8 studies (710 patients) demonstrated that plasma sPD-L1 levels were associated with the clinical outcome of tumor patients and might serve as a predicting biomarker of OS in NSCLC patients given with ICI-based therapies [74].…”

Pre-treatment soluble PD-L1 as a predictor of overall survival for immune checkpoint inhibitor therapy: a systematic review and meta-analysis

“…In contrast, in NSCLC studies, high sPD-L1 levels consequently tended to be associated with shorter patient survival in ICI-treated patients. This finding is in line with the previous meta-analysis by Liao et al ., suggesting that low rather than high sPD-L1 levels might have predictive values for ICI treatment [ 50 ].…”

Prognostic and predictive role of soluble programmed death ligand-1 in head and neck cancer

“…So far, the results are contrasting: in a metastatic renal cell carcinoma higher level of sPD-L1 is associated with longer progression-free survival, 8 but on the other hand, studies regarding a non-small cell lung carcinoma and a melanoma indicate worse treatment outcomes for patients with high expression of sPD-L1. 9 , 10 , 11 …”