{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T20:15:21Z","timestamp":1794255321680,"version":"4.9.0"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Programmed death ligand-1 (PD-L1) expression on circulating tumor cells (CTCs) has been suggested to provide prognostic information in non-small cell lung cancer (NSCLC), but consensus relative to treatment outcomes is lacking. We conducted the first comprehensive meta-analysis exploring its potential as a prognostic and predictive marker, and assessed the concordance between PD-L1 + CTCs and paired tumor tissue in NSCLC patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>A comprehensive search was applied to PubMed and EMBASE to identify 26 studies that evaluated PD-L1 + CTCs and their association with survival outcomes in 1236 NSCLC patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The meta-analysis estimated a mean PD-L1 + CTCs detection rate of 61% (95% CI, 49\u201372). Subgroup analysis based on treatment showed that PD-L1 + CTCs was not significantly associated with better overall survival (OS) in NSCLC patients treated with immune checkpoint inhibitors (ICIs) (Hazard Ratio (HR) = 0.96, 95% CI, 0.35\u20132.65, P = 0.944), but was predictive of worse OS in those treated with other therapies (HR = 2.11, 95% CI, 1.32\u20133.36, P = 0.002). Similarly, PD-L1 + CTCs was not significantly associated with superior progressing free survival (PFS) in NSCLCs treated with ICIs (HR = 0.67, 95% CI, 0.41\u20131.09, P = 0.121), but was significantly associated with shorter PFS in patients treated with other therapies (HR = 1.91, 95% CI, 1.24\u20132.94, P = 0.001). The overall estimate for the concordance between PD-L1 expression on CTCs and tumor cells was 63% (95% CI, 44\u201380).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The average detection rate of PD-L1 + CTCs was comparable to the rate of PD-L1 expression in NSCLC tumors. There was a trend towards better PFS in ICI-treated NSCLC patients with PD-L1 + CTCs. Larger longitudinal studies on the association of PD-L1 + CTCs with clinical outcomes in NSCLC patients treated with ICIs are warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/clinchem\/hvad187","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T16:25:25Z","timestamp":1704385525000},"page":"234-249","source":"Crossref","is-referenced-by-count":14,"title":["Meta-Analysis of Circulating Tumor Cell PD-L1 Expression and the Association with Clinical Outcomes in Non-Small Cell Lung Cancer"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5338-3258","authenticated-orcid":false,"given":"Emmanuel","family":"Acheampong","sequence":"first","affiliation":[{"name":"Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester , Leicester , United Kingdom"},{"name":"Institute of Precision Health, University of Leicester , Leicester , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4887-8632","authenticated-orcid":false,"given":"Rebecca C","family":"Allsopp","sequence":"additional","affiliation":[{"name":"Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester , Leicester , United Kingdom"},{"name":"Institute of Precision Health, University of Leicester , Leicester , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Page","sequence":"additional","affiliation":[{"name":"Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester , Leicester , United Kingdom"},{"name":"Institute of Precision Health, University of Leicester , Leicester , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc K","family":"Wadsley","sequence":"additional","affiliation":[{"name":"Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester , Leicester , United Kingdom"},{"name":"Institute of Precision Health, University of Leicester , Leicester , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron B","family":"Beasley","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Edith Cowan University , Perth, Joondalup, WA , Australia"},{"name":"Centre for Precision Health, Edith Cowan University , Joondalup, WA , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Charles","family":"Coombes","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith, Hospital Campus , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqui A","family":"Shaw","sequence":"additional","affiliation":[{"name":"Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester , Leicester , United Kingdom"},{"name":"Institute of Precision Health, University of Leicester , Leicester , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8613-3570","authenticated-orcid":false,"given":"Elin S","family":"Gray","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Edith Cowan University , Perth, Joondalup, WA , Australia"},{"name":"Centre for Precision Health, Edith Cowan University , Joondalup, WA , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"2024012006453632700_hvad187-B1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1056\/NEJMoa1916623","article-title":"The effect of advances in lung-cancer treatment on population mortality","volume":"383","author":"Howlader","year":"2020","journal-title":"N Eng J 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