2022 World Conference on Lung Cancer (ePosters)-EP08.01-028. Overestimation with Cox HR - Cox-TEL-Adjusted Associations of PD-L1 Expression with Immune Checkpoint Inhibitor Survival Benefit in Lung Cancer

EP08.01-028. Overestimation with Cox HR - Cox-TEL-Adjusted Associations of PD-L1 Expression with Immune Checkpoint Inhibitor Survival Benefit in Lung Cancer

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A recent study analyzed the survival benefit of immune checkpoint inhibitor (ICI) therapy in lung cancer patients with varying levels of PD-L1 expression. The study reviewed 16 clinical trials and included nine publications representing eight clinical trials. Key findings from the study include a 10% long-term survival probability increment in ICI long-term survivors across PD-L1 positive subpopulations in both ICI treatment lines. However, the study also found that ST-HR (short-term hazard ratio) consistently underestimated the survival benefit compared to unadjusted (biased) Cox HR (hazard ratio). For patients with PD-L1 1%, neither the long-term survival probability increment (LT-DP) nor the ST-HR achieved statistical significance.<br /><br />In the primary analysis, the pooled LT-DP and ST-HR were not statistically significant for the PD-L1 1% subpopulation, while the PD-L1 50% subpopulation showed a significant long-term survival probability increment. In the secondary analysis, the trend of pooled LT-DP coincided with the PD-L1 expression in both ICI treatment lines. The pooled ST-HR was greater in the ICI first-line setting compared to the ICI second-line setting, indicating a smaller percent reduction of risk with ICI in the first-line setting.<br /><br />Overall, the study suggests an overestimation of the survival benefit of ICI therapy in published trials. The findings highlight the importance of considering PD-L1 expression and treatment line when assessing the efficacy of ICI therapy in lung cancer patients. The study contributes to a better understanding of the association between PD-L1 expression and ICI survival benefit, providing valuable insights for clinical decision-making and future research in this field.

Asset Subtitle

Emily Pei-Ying Lin

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Speaker Emily Pei-Ying Lin

Topic Metastatic Non-small Cell Lung Cancer - Immunotherapy

Keywords

study

immune checkpoint inhibitor therapy

lung cancer patients

PD-L1 expression

survival benefit

clinical trials

long-term survival probability

ST-HR

hazard ratio

ICI treatment lines