Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Plasma Cell-free RNA PD-L1 Expression and Overall Survival of Immune Checkpoint Inhibitor Therapy in Advanced Non-Small Cell Lung Cancer

Version 1 : Received: 14 July 2022 / Approved: 11 August 2022 / Online: 11 August 2022 (06:10:34 CEST)

How to cite: Walker, P.R.; Muzzafar, M.; Jayananda, S.; Namireddy, P.; Sharma, N.; Parent, T.; Cherry, C.; Lanman, R.B. Plasma Cell-free RNA PD-L1 Expression and Overall Survival of Immune Checkpoint Inhibitor Therapy in Advanced Non-Small Cell Lung Cancer. Preprints 2022, 2022080208 (doi: 10.20944/preprints202208.0208.v1). Walker, P.R.; Muzzafar, M.; Jayananda, S.; Namireddy, P.; Sharma, N.; Parent, T.; Cherry, C.; Lanman, R.B. Plasma Cell-free RNA PD-L1 Expression and Overall Survival of Immune Checkpoint Inhibitor Therapy in Advanced Non-Small Cell Lung Cancer. Preprints 2022, 2022080208 (doi: 10.20944/preprints202208.0208.v1).

Abstract

Tissue programmed death ligand-1 (PD-L1) protein expression is predictive of immune checkpoint inhibitor (ICI) benefit. However, tissue PD-L1 can be fraught with tissue acquisition and heterogeneity limitations. Plasma testing can overcome these limitations. However, the overall survival (OS) predictive benefit of plasma PD-L1 assays have not been well characterized. Patients with stage IV non-small cell lung cancer (NSCLC) and plasma cfRNA PD-L1 by PCR expression were identified and assessed for OS. 16 patients treated with front-line ICI-based regimens were assessed and represented a real-world patient population with over half with a performance status of 2 or greater. 10 contemporaneous patients at the same institution treated with chemotherapy alone were also identified and assessed. With a median follow-up of 33 months, median OS was 13 months with a 30% 3-year OS for the ICI treated patients compared to a median OS of 3 months and a 10% 3-year OS for those treated with chemotherapy alone. Comparative log-rank test p-value = 0.014 and a hazard ratio 0.376 (95%-CI 0.134-1.057). Plasma cfRNA PD-L1 was associated with a statistically significant survival benefit from ICI-based treatment compared to chemotherapy in the first line treatment of a real-world patient population of advanced NSCLC.

Keywords

Plasma PD-L1; liquid biopsy; cfRNA; immune checkpoint inhibitor; predictive immune biomarker; NSCLC

Subject

MEDICINE & PHARMACOLOGY, Oncology & Oncogenics

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