{"doi":"10.1200/po.22.00457","title":"Monitoring PD-L1 Expression on Circulating Tumor–Associated Cells in Recurrent Metastatic Non–Small-Cell Lung Carcinoma Predicts Response to Immunotherapy With Radiation Therapy","abstract":"PURPOSE Current diagnostic methods to determine programmed death 1 (PD-1) receptor and its ligand (PD-L1)/PD-1 immunotherapy (immune checkpoint inhibitor [ICI]) efficacy in recurrent or metastatic non–small-cell lung carcinoma (rmNSCLC) are imprecise. Although previously shown that patients with high tumor PD-L1 (≥ 50%) demonstrate clinical benefit in the form of disease reduction and improved survival, patients with low PD-L1 (< 50%) sometimes benefit from treatment. Since the PD-L1/PD-1 pathway is dynamic, monitoring PD-L1 levels during treatment may be more accurate than a static baseline tumor biopsy; however, rebiopsying the primary or metastatic disease is rarely feasible. Liquid biopsies that measure the upregulation of PD-L1 on tumor-associated cells (TACs), ie, cancer-associated macrophage-like cells and circulating tumor cells, have been performed, but their predictive value for ICI therapy efficacy is unknown. MATERIALS AND METHODS We initiated a single-blind prospective study to evaluate TAC PD-L1 expression changes in rmNSCLC from blood samples before (T0) and after (T1) treatment with ICI (ICI, n = 41) or without ICI (no ICI, n = 41). Anonymized blood was filtered to isolate TACs, which were then quantified for high/low PD-L1 expression. Progression-free survival (PFS) or overall survival (OS) hazard ratios (HRs) were evaluated at 18 and 24 months by censored univariate analysis. RESULTS Increased TAC PD-L1 expression between T0 and T1 in patients who were not treated with ICI had no relationship with PFS or OS. However, increased TAC PD-L1 expression between T0 and T1 in patients treated with ICI had significantly better PFS (HR, 3.49; 95% CI, 1.5 to 8.3; P = .0091) and OS (HR, 3.058; 95% CI, 1.2 to 7.9; P = .0410). CONCLUSION Blood-based monitoring of dynamic changes in PD-L1 in TACs appears to identify patients with rmNSCLC who may benefit from ICI.","journal":"JCO Precision Oncology","year":2022,"id":242458,"datarank":0.5495342469194471,"base_score":3.6635616461296463,"endowment":3.6635616461296463,"self_citation_contribution":0.5495342469194471,"citation_network_contribution":0.0,"self_endowment_contribution":0.5495342469194471,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":38,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":338834,"name":"Daniel L. Adams","orcid":"0000-0002-1916-9637","position":1,"is_corresponding":false},{"id":574720,"name":"Martin J. Edelman","orcid":"0000-0002-3752-0726","position":2,"is_corresponding":false},{"id":872968,"name":"Pablo Lopez","orcid":"0000-0002-4282-3123","position":3,"is_corresponding":false},{"id":338835,"name":"Jianzhong He","orcid":"0000-0003-1256-472X","position":4,"is_corresponding":false},{"id":340612,"name":"Yawei Qiao","orcid":null,"position":5,"is_corresponding":false},{"id":344753,"name":"Ting Xu","orcid":"0000-0002-7851-3389","position":6,"is_corresponding":false},{"id":308376,"name":"Zhongxing Liao","orcid":"0000-0002-2224-9478","position":7,"is_corresponding":false},{"id":574729,"name":"Kirby P. Gardner","orcid":"0000-0003-4537-1465","position":8,"is_corresponding":false},{"id":574726,"name":"Cha‐Mei Tang","orcid":"0000-0003-3017-0732","position":9,"is_corresponding":false},{"id":236019,"name":"Steven H. Lin","orcid":"0000-0003-4411-0634","position":10,"is_corresponding":false},{"id":817091,"name":"Jillian Moran","orcid":"0000-0002-8686-2714","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:23:05.485568Z","pmid":"36516370","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}