Woodford, RachelRachelWoodfordZhou, DeborahDeborahZhouLord, Sarah JSarah JLordMarschner, IanIanMarschnerCooper, Wendy AWendy ACooperLewis, Craig RCraig RLewisJohn, ThomasThomasJohnCHIH-HSIN YANGLee, Chee KhoonChee KhoonLee2023-03-022023-03-022022-051479-6694https://scholars.lib.ntu.edu.tw/handle/123456789/628833Background: In metastatic non-small-cell lung cancer (mNSCLC), PD-L1 expression is associated with benefit from immune checkpoint inhibitor (ICI) therapy. However, the significance of PD-L1 expression in chemotherapy-treated patients is uncertain. Methods: Using the chemotherapy control arm of first-line randomized trials, a meta-analysis of the association between efficacy outcomes and PD-L1 status was performed, stratified by assay due to inter-assay differences. Results: Across 12 trials and 4378 patients, overall survival (OS) was superior in high PD-L1 versus negative tumors and low versus negative according to 22C3/28-8 assays. When classified by SP142 assay, no significant difference in response or survival was seen between PD-L1 groups. Conclusion: In mNSCLC, high PD-L1-expressing tumors are associated with longer OS and improved objective rate when treated with chemotherapy. Inter-assay variability impacts outcome results.enPD-L1; biomarkers; chemotherapy; metastatic cancer; non-small-cell lung cancer; prognostic markers[SDGs]SDG3review10.2217/fon-2021-1184351568372-s2.0-85128488477WOS:000756242800001https://api.elsevier.com/content/abstract/scopus_id/85128488477