Meta-analysis of association of PD-L1 expression and other variables with benefit from ICI for advanced GEC

Approval by the FDA of immune checkpoint inhibition (ICI) for advanced gastroesophageal cancer (aGEC) irrespective of PD-L1 status has generated controversy. Exploratory analysis from individual trials indicate a lack of meaningful benefit from ICI in patients with low PD-L1 expression; however, analysis of a single variabel while ignoring others may not consider the instability inherent in exploratory analyses. A meta-analysis of 17 randomized controlled trials (11,166 patients) evaluated the predictive value of tissue-based PD-L1 status compared with 13 other variables. The meta-analysis found that tissue-based PD-L1 expression, more than any variable other than microsatellite instability-high, identified varying degrees of benefit from ICI-containing therapy versus standard of care among patients with aGEC.