WCLC 2025 - Posters & ePosters-EP.11.02 Four Year-Experience With Immunotherapy in First Line Treatment of Advanced Lung Cancer in Patients With High and Very High Expression of PD-L1

EP.11.02 Four Year-Experience With Immunotherapy in First Line Treatment of Advanced Lung Cancer in Patients With High and Very High Expression of PD-L1

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This study presents a four-year real-world experience with first-line immunotherapy in advanced non-small cell lung cancer (NSCLC) patients exhibiting high (50-89%) and very high (≥90%) PD-L1 expression. Conducted at Hospital Universitario Clínico San Cecilio in Granada, Spain, the retrospective observational analysis included metastatic NSCLC patients treated with immune checkpoint inhibitors (ICIs) such as pembrolizumab, cemiplimab, or atezolizumab.<br /><br />The patient cohorts with PD-L1 expression levels of 50–89% and ≥90% were largely balanced in clinical and demographic characteristics, except that brain metastases were more frequent in the ≥90% PD-L1 group. Overall, the median objective response rate (ORR) was approximately 30%, with a median progression-free survival (PFS) of 5 months and median overall survival (OS) of 9 months across the entire population. Importantly, no statistically significant differences in PFS or OS were observed between the two PD-L1 expression groups.<br /><br />The findings suggest that, despite high PD-L1 expression generally being predictive of better ICI response, a subset of patients may not derive substantial benefit from monotherapy with ICIs. This highlights the need for further research aimed at identifying the clinical and biological factors that characterize this subgroup. Understanding these factors is critical to developing alternative therapeutic strategies that improve outcomes for these patients.<br /><br />In summary, while PD-L1 expression remains a valuable biomarker for guiding immunotherapy in metastatic NSCLC, real-world data indicate variability in treatment efficacy, underscoring the importance of personalized approaches and continued investigation into resistant patient populations.

Asset Subtitle

Silvia Sequero López

Meta Tag

Speaker Silvia Sequero López

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

non-small cell lung cancer

NSCLC

PD-L1 expression

immune checkpoint inhibitors

pembrolizumab

cemiplimab

atezolizumab

progression-free survival

overall survival

immunotherapy resistance