WCLC 2025 - Posters & ePosters-EP.07.38 Immune Checkpoint Inhibitors May Not Fully Mitigate the Adverse Prognostic Impact of PD-L1 Expression in Early Lung Cancer

EP.07.38 Immune Checkpoint Inhibitors May Not Fully Mitigate the Adverse Prognostic Impact of PD-L1 Expression in Early Lung Cancer

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This study investigated the prognostic impact of PD-L1 expression in early-stage (stage I) non-small cell lung cancer (NSCLC) and the effectiveness of immune checkpoint inhibitors (ICIs) in mitigating adverse outcomes. A retrospective analysis was conducted on 141 patients who underwent complete lung cancer resection at Tohoku University Hospital between 2017 and 2018. Patients were divided into PD-L1 positive (69) and PD-L1 negative (72) groups, and clinical, pathological, and survival outcomes were compared.<br /><br />Key findings indicated that PD-L1 positive tumors were associated with more aggressive pathological features, including higher rates of squamous cell carcinoma histology, greater invasive tumor size, more pleural, vascular, and lymphatic invasion, and higher stage IB disease. Survival analysis showed that patients with PD-L1 negative tumors had significantly better overall survival (OS) and recurrence-free survival (RFS) compared to PD-L1 positive patients.<br /><br />The study also evaluated the use of ICIs after recurrence in PD-L1 positive patients, especially those without driver mutations. Although ICIs are expected to be effective for PD-L1 expressing cancers, among five such patients treated with ICIs post-relapse, two were untreatable and had poor outcomes. This suggests that ICIs may not fully overcome the negative prognostic impact associated with PD-L1 expression in early lung cancer.<br /><br />In conclusion, PD-L1 expression correlates with greater malignancy and worsened prognosis in early-stage lung cancer. While immune checkpoint inhibitors offer a promising treatment option, their use after recurrence may not completely mitigate the adverse outcomes linked to PD-L1 positivity in this setting. Thus, PD-L1 remains an important prognostic factor, and further strategies are needed to improve outcomes for PD-L1 positive early lung cancer patients.

Asset Subtitle

Ken Onodera

Meta Tag

Speaker Ken Onodera

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

PD-L1 expression

early-stage non-small cell lung cancer

NSCLC

immune checkpoint inhibitors

ICIs

prognostic impact

lung cancer resection

overall survival

recurrence-free survival

tumor aggressiveness