Baseline PD-L1 expression on circulating immune cells as a predictor of survival and immune-related adverse events in extensive-stage small-cell lung cancer patients treated with durvalumab and carboplatin-etoposide (NCT04712903 Trial)
Por:
Piedra, A, Guinart-Cuadra, A, Martínez-Recio, S, Mulet, M, Zamora, C, Osuna-Gómez, R, Cantó, E, Ortiz, MA, Alejandre, J, Barba, A, Sanz-Beltrán, J, Serra-López, J, Isla, D, Arriola, E, Paz-Ares, L, Diz-Taín, MP, Moreno, AL, Callejo, A, Vidal, S, Majem, M
Publicada:
28 feb 2026
Ahead of Print:
1 feb 2026
Resumen:
Introduction Despite improved efficacy with first-line immune checkpoint inhibitors plus platinum-based chemotherapy for extensive-stage small cell lung cancer (ES-SCLC), long-term survival remains limited. There is currently no available predictive biomarker to identify which patients would benefit most from this treatment. We hypothesized that pre-treatment PD-L1 expression on circulating immune cells might predict survival outcomes and toxicity. Material and methods This prospective, multi-center observational study included patients with untreated ES-SCLC treated with first-line durvalumab plus platinum-based chemotherapy. The percentages of circulating PD-L1(+) immune cells at baseline were analysed by flow cytometry to assess their association with survival outcomes and the development of immune-related adverse events (irAEs). Results Among 41 patients with ES-SCLC, 65.9% were male, 73.2% had an ECOG-PS 1, 9.8% had central nervous system (CNS) metastases and 31.7% had liver metastases. Sixteen patients (39%) experienced irAEs. Median PFS was longer in patients with high percentages of circulating PD-L1(+) monocytes compared to those with low percentages: 8.97 months (95% CI NR to NR) vs. 5.97 months (95% CI 4.65 to 7.28), p = 0.007. There was a trend toward longer median OS in patients with ES-SCLC and high percentages of circulating PD-L1(+) monocytes versus low percentages: NR (95% CI NR-NR) vs. 9.13 months (95% CI 6.34 to 11.92), p = 0.092. Patients with higher circulating PD-L1(+) neutrophils correlated with the development of irAES (p = 0.007). Conclusions Our results showed a statistically significant longer PFS in patients with ES-SCLC and high percentages of circulating PD-L1(+) monocytes. This suggests PD-L1 expression on monocytes might be established as a predictive biomarker for patients with ES-SCLC treated with upfront chemo-immunotherapy. Trial registration NCT04712903 Trial. Last registered 1 December 2025, https://www.clinicaltrials.gov/study/NCT04712903.
Filiaciones:
Piedra, A:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Guinart-Cuadra, A:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Autonomous Univ Barcelona, Dept Cell Biol Physiol & Immunol, Bellaterra, Spain
Ctr Biomed Res Liver & Digest Dis Network CIBERehd, Madrid, Spain
Martínez-Recio, S:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Mulet, M:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Zamora, C:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Osuna-Gómez, R:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Cantó, E:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Ortiz, MA:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Alejandre, J:
Inst Recerca St Pau IR St PAU, Inflammatory Dis, St Quniti 77-79, Barcelona 08041, Spain
Barba, A:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Sanz-Beltrán, J:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Serra-López, J:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Isla, D:
Hosp Univ Lozano Blesa, Med Oncol Dept, Zaragoza, Spain
Arriola, E:
Hosp Del Mar CIBERONC, Med Oncol Dept, Barcelona, Spain
Paz-Ares, L:
Hosp Univ 12 Octubre, Med Oncol Dept, Madrid, Spain
Diz-Taín, MP:
Complejo Asistencial Univ Leon, Med Oncol Dept, Leon, Spain
Moreno, AL:
Hosp Univ Reina Sofia, Med Oncol Dept, Cordoba, Spain
Callejo, A:
AstraZeneca Farmaceut Spain, Madrid, Spain
Vidal, S:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Majem, M:
Hosp La Santa Creu & St Pau, Med Oncol Dept, St Quinti 89, Barcelona 08025, Spain
Green Submitted, gold
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