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Background <p>PD-L1 expression in <i>ROS1</i>-positive non-small cell lung carcinoma (NSCLC) patients remains unclear regarding its possible clinical-biological role.</p> Methods <p>A retrospective, descriptive study of 24 <i>ROS1</i>-positive NSCLC patients (2013–2023) from five Spanish hospitals were evaluated. Manual (clone SP263) PD-L1 tumour proportion score (TPS) was also subjected to two artificial intelligence (AI) testing algorithms. Clinical and molecular data categorized according to PD-L1 levels by double independent review, were retrospectively collected and, potential correlations were analysed.</p> Results <p>The median age was 60&#xa0;years (46–85), female (54.1%), adenocarcinoma (87.5%), and former/never smokers (83.3%). Predominant <i>ROS1</i> fusion partner (FP) was <i>CD74</i> (41.6%). Most patients (79.1%) received crizotinib at some point during their treatment. PDL1 TPS 1–49% (41.7%), ≥ 50% (33.3%), and &lt; 1% (25%). Statistically significant association between the <i>ROS1</i> FP category and PD-L1 TPS ≥ 50% (p = 0.008), specifically with <i>EZR</i> (mean manual TPS: 62.1) was found. No statistically significant associations for clinical categorical variables and PD-L1 TPS were observed. Although no significant difference among PD-L1 TPS categories in terms of overall survival was detected (p = 0.36), a shorter overall survival was noted in patients with TPS ≥ 50% and <i>EZR</i>. No significant differences were found between the manual PD-L1 TPS evaluation and the use of PD-L1-based AI algorithms.</p> Conclusions <p>PD-L1 expression may have a biological significance in <i>ROS1</i>-positive NSCLC, particularly when associated with the <i>EZR</i> FP and PD-L1 TPS ≥ 50% which determines a lower overall survival. No significant differences were found between manual PD-L1 TPS evaluation and the use of AI.</p>

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PD-L1 expression scoring using artificial intelligence algorithms in non-small cell lung cancer harbouring ROS1 fusions: potential clinical-biological significance

  • 期刊论文

  • 发表日期：

    2025年8月11日

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  • Luis Fernando García,
  • Esther Conde,
  • Susana Hernandez,
  • Marta Alonso,
  • Daniel Curto,
  • Manuel Dómine,
  • Federico Rojo,
  • Javier Freire,
  • Javier Gómez-Román,
  • Antonio Calles,
  • María Cebollero,
  • José Luis González-Larriba,
  • Melchor Saiz,
  • Isabel Esteban,
  • Laura Gutiérrez,
  • Fernando Lopez-Rios,
  • Javier de Castro

摘要

Background

PD-L1 expression in ROS1-positive non-small cell lung carcinoma (NSCLC) patients remains unclear regarding its possible clinical-biological role.

Methods

A retrospective, descriptive study of 24 ROS1-positive NSCLC patients (2013–2023) from five Spanish hospitals were evaluated. Manual (clone SP263) PD-L1 tumour proportion score (TPS) was also subjected to two artificial intelligence (AI) testing algorithms. Clinical and molecular data categorized according to PD-L1 levels by double independent review, were retrospectively collected and, potential correlations were analysed.

Results

The median age was 60 years (46–85), female (54.1%), adenocarcinoma (87.5%), and former/never smokers (83.3%). Predominant ROS1 fusion partner (FP) was CD74 (41.6%). Most patients (79.1%) received crizotinib at some point during their treatment. PDL1 TPS 1–49% (41.7%), ≥ 50% (33.3%), and < 1% (25%). Statistically significant association between the ROS1 FP category and PD-L1 TPS ≥ 50% (p = 0.008), specifically with EZR (mean manual TPS: 62.1) was found. No statistically significant associations for clinical categorical variables and PD-L1 TPS were observed. Although no significant difference among PD-L1 TPS categories in terms of overall survival was detected (p = 0.36), a shorter overall survival was noted in patients with TPS ≥ 50% and EZR. No significant differences were found between the manual PD-L1 TPS evaluation and the use of PD-L1-based AI algorithms.

Conclusions

PD-L1 expression may have a biological significance in ROS1-positive NSCLC, particularly when associated with the EZR FP and PD-L1 TPS ≥ 50% which determines a lower overall survival. No significant differences were found between manual PD-L1 TPS evaluation and the use of AI.