The influence of PD‑L1 expression levels on the efficacy of combination therapy in thymic epithelial tumors

Han Si; Xiaoshuang Fu; Yue Hao; Yina Wang; Gen Lin; Dong Wang; Chunwei Xu; Yongchang Zhang; Zhengbo Song

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The influence of PD‑L1 expression levels on the efficacy of combination therapy in thymic epithelial tumors

Han Si ^[4] ; Xiaoshuang Fu ^[4] ; Yue Hao ^[5] ; Yina Wang ^[1] ; Gen Lin ^[2] ; Dong Wang ^[3] ; Chunwei Xu ^[6] ; Yongchang Zhang ^[7] ; Zhengbo Song ^[4]
1. [1] Zhejiang University
  
  Zhejiang University
  
  China
2. [2] Fujian Medical University
  
  Fujian Medical University
  
  China
3. [3] Nanjing University
  
  Nanjing University
  
  China
4. [4] Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China
5. [5] Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou 310022, Zhejiang, China
6. [6] Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou 310022, Zhejiang, China
7. [7] Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
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Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 27, Nº. 2, 2025, págs. 542-548
Idioma: inglés
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Resumen
- Background The significant expression of PD-L1 in thymic epithelial tumors (TETs) has been confirmed, and immunotherapy and its combination therapy have been effective in TETs. However, there is no present evidence that the expression levels of PD-L1 affects the efficacy of combination therapy. Our study aimed to shed light on this relationship.
  
  Methods Patients with thymic epithelial tumors (TETs) from multicenter hospitals were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) in 22 patients were included. We divided the patients the 22 patients with PD-L1 test into three levels (high expression, low expression and no expression) and analyzed the relationship between the levels of PD-L1 expression and the efficacy of combination therapy.
  
  Results Combination therapy showed an effective benefit in 22 patients with TETs, the median PFS (mPFS) was 16 months (95% CI: 8.5–23.5) and the median OS (mOS) was 38 months (95% CI: 21.5–54.5). Cox-regressive analysis found whether PD-L1 expression affected the PFS of patients (p = 0.017). Among the patients with PD-L1 expression, the levels of expression were correlated with curative effect (Kruskal–Wallis test, PFS: P = 0.012; OS: P = 0.01), and high expression group was along with better efficacy than low expression (Wilcoxon test, P = 0.01). Moreover, in 17 patients treated with immunotherapy combined with chemotherapy, the expression of PD-L1 was also associated with efficacy (Kruskal–Wallis test, p = 0.021).
  
  Conclusions PD-L1 expression affects the PFS of patients. High expression of PD-L1 patients with TETs responded better to combination therapy, which could provide a therapeutic option in clinic. Besides, other targeted treatments should be considered.