Soluble PD-L1 as a Predictive Biomarker in Lung Cancer: A Systematic Review and Meta-Analysis

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Background: We performed a meta-analysis to evaluate the association between soluble PD-L1 (sPD-L1) and survival outcomes and treatment response in lung cancer. Methods & methods: Eligible studies were obtained by searching PubMed, EMBASE and Web of Science. Pooled effect estimates were calculated for overall survival (OS), progression-free survival (PFS) and objective response rate (ORR). Results: Twelve eligible studies with 1188 lung cancer patients were included. High sPD-L1 was significantly associated with worse OS (hazard ratio [HR] = 2.20; 95% CI: 1.59–3.05; p < 0.001) and PFS (HR = 2.42; 95% CI: 1.72–3.42; p < 0.001) in patients treated with immune checkpoint inhibitors (ICIs). Meanwhile, high sPD-L1 predicted worse OS (HR = 1.60; 95% CI: 1.31–1.96; p < 0.001) and lower ORR (odds ratio = 0.52; 95% CI: 0.35–0.80; p = 0.002) in patients treated with non-ICI therapies. Conclusion: sPD-L1 is a potential predictive biomarker of lung cancer.