Durable clinical benefit and progression-free survival in patients with PD-L1 ≥50% NSCLC receiving pembrolizumab: Impact of nutritional and inflammatory markers.
[BACKGROUND] Immune checkpoint inhibitors (ICIs) are effective in advanced non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50 %; however, responses remain heterogeneous.
- p-value p = 0.088
APA
Yamakawa H, Kusano K, et al. (2026). Durable clinical benefit and progression-free survival in patients with PD-L1 ≥50% NSCLC receiving pembrolizumab: Impact of nutritional and inflammatory markers.. Cancer treatment and research communications, 47, 101142. https://doi.org/10.1016/j.ctarc.2026.101142
MLA
Yamakawa H, et al.. "Durable clinical benefit and progression-free survival in patients with PD-L1 ≥50% NSCLC receiving pembrolizumab: Impact of nutritional and inflammatory markers.." Cancer treatment and research communications, vol. 47, 2026, pp. 101142.
PMID
41722506
Abstract
[BACKGROUND] Immune checkpoint inhibitors (ICIs) are effective in advanced non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50 %; however, responses remain heterogeneous. We investigated the predictive value of nutritional and inflammatory indices (Prognostic Nutritional Index [PNI], Geriatric Nutritional Risk Index [GNRI], and neutrophil-to-lymphocyte ratio [NLR]), for durable clinical benefit (DCB) and progression-free survival (PFS) in this population.
[METHODS] We retrospectively analyzed 125 patients (ECOG PS 0-2) with advanced NSCLC and PD-L1 ≥50 % treated with pembrolizumab. A composite score (0-3) was defined by PNI <45, GNRI <92, and NLR ≥5 (1 point each). DCB predictors were evaluated by prespecified multivariable logistic regression (PS, smoking, stage, ILD as forced covariates), and PFS/OS by Kaplan-Meier and multivariable Cox models with landmark OS. DCB was non-progressive disease sustained for ≥6 months (monotherapy) or ≥10 months (chemo-immunotherapy).
[RESULTS] Among 125 patients, 65.6 % achieved DCB. In multivariable logistic regression, PS was independently associated with DCB; the composite score showed a borderline association (p = 0.088), whereas NLR ≥5 was independently associated with lower odds of DCB. PFS was longer with NLR <5, but in adjusted Cox models neither the composite score nor NLR independently predicted PFS/OS; PS remained significant. ILD was not associated with DCB or PFS.
[CONCLUSIONS] In PD-L1-high advanced NSCLC treated with pembrolizumab, PS was the most consistent determinant. Higher inflammation (NLR ≥5) was linked to lower odds of DCB, whereas the composite nutritional-inflammatory score should be regarded as an exploratory host-summary rather than a definitive prognostic index.
[METHODS] We retrospectively analyzed 125 patients (ECOG PS 0-2) with advanced NSCLC and PD-L1 ≥50 % treated with pembrolizumab. A composite score (0-3) was defined by PNI <45, GNRI <92, and NLR ≥5 (1 point each). DCB predictors were evaluated by prespecified multivariable logistic regression (PS, smoking, stage, ILD as forced covariates), and PFS/OS by Kaplan-Meier and multivariable Cox models with landmark OS. DCB was non-progressive disease sustained for ≥6 months (monotherapy) or ≥10 months (chemo-immunotherapy).
[RESULTS] Among 125 patients, 65.6 % achieved DCB. In multivariable logistic regression, PS was independently associated with DCB; the composite score showed a borderline association (p = 0.088), whereas NLR ≥5 was independently associated with lower odds of DCB. PFS was longer with NLR <5, but in adjusted Cox models neither the composite score nor NLR independently predicted PFS/OS; PS remained significant. ILD was not associated with DCB or PFS.
[CONCLUSIONS] In PD-L1-high advanced NSCLC treated with pembrolizumab, PS was the most consistent determinant. Higher inflammation (NLR ≥5) was linked to lower odds of DCB, whereas the composite nutritional-inflammatory score should be regarded as an exploratory host-summary rather than a definitive prognostic index.