WCLC 2025 - Posters & ePosters-P2.08 .35 PD-L1 as a Predictive Biomarker in EGFR-Mutated Non-Small Cell Lung Cancer With Neoadjuvant Immunochemotherapy

P2.08 .35 PD-L1 as a Predictive Biomarker in EGFR-Mutated Non-Small Cell Lung Cancer With Neoadjuvant Immunochemotherapy

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This retrospective study evaluated the role of PD-L1 as a predictive biomarker in EGFR-mutated non-small cell lung cancer (EGFR-M NSCLC) treated with neoadjuvant immunochemotherapy. Two patient cohorts were analyzed: a NeoGroup (43 stage IB-IV patients receiving combined immunotherapy and chemotherapy followed by surgery) and an AdjGroup (499 stage IB-III patients undergoing surgery without neoadjuvant therapy). The study aimed to assess the association between PD-L1 tumor proportion score (TPS), treatment response, pathological features, and genomic alterations.<br /><br />Key findings include:<br /><br />- In the NeoGroup, the objective response rate was 44.2%, with pathological complete response (pCR) in 18.6% and major pathological response (MPR) in 41.9%. Baseline PD-L1 TPS ≥1% correlated with significantly better radiological responses (partial response in 78.9% vs. stable disease 59.1% vs. progression 0%; p ≤0.05).<br />- Patients achieving MPR demonstrated a greater increase in PD-L1 TPS after neoadjuvant therapy (p =0.0195), indicating dynamic PD-L1 changes as a predictor of efficacy.<br />- In the AdjGroup, baseline PD-L1 TPS ≥50% was associated with more aggressive pathological characteristics (p ≤0.05). <br />- PD-L1 ≥1% patients more frequently carried TP53 mutations and were more often in the MPR category, although these differences were not statistically significant.<br />- The study also detailed various genomic mutation profiles across the cohorts, but the main actionable message highlights PD-L1 as a predictive biomarker for neoadjuvant immunochemotherapy in EGFR-M NSCLC.<br /><br />Conclusion: Higher baseline PD-L1 expression and an increased PD-L1 level post-therapy are linked to improved treatment responses in EGFR-mutated NSCLC undergoing neoadjuvant immunochemotherapy. PD-L1 TPS assessment may guide therapeutic decisions and predict efficacy in this patient population.

Asset Subtitle

Yi-Fan Qi

Meta Tag

Speaker Yi-Fan Qi

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

PD-L1

EGFR-mutated non-small cell lung cancer

neoadjuvant immunochemotherapy

tumor proportion score

pathological complete response

major pathological response

radiological response

TP53 mutations

genomic alterations

predictive biomarker