Cancer Research and Treatment

Original Articles

Non-response to Durvalumab and Supraclavicular Nodal Involvement Predict Early Brain Metastasis after Concurrent Chemoradiotherapy Followed by Durvalumab Consolidation in Stage III Non–Small Cell Lung Cancer: Yoo Kyung Choi, Yeon-Sil Kim, Yoo-Kang Kwak, Yun Hee Lee, Sung-Hwan Kim, Soo-Yoon Sung, Seok Hyun Son, Kyu Hye Choi; Received November 11, 2025 Accepted February 19, 2026 Published online February 20, 2026; DOI: https://doi.org/10.4143/crt.2025.1244 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
This study aimed to identify predictors of brain metastasis in patients with unresectable stage III non–small cell lung cancer (NSCLC) treated with definitive concurrent chemoradiotherapy (CCRT) followed by durvalumab consolidation.
Materials and Methods
We retrospectively analyzed 138 patients with unresectable stage III NSCLC treated with definitive CCRT followed by durvalumab from 2018 to 2024. The primary endpoint was brain metastasis incidence. Univariate and multivariate logistic regression analyses identified factors associated with brain metastasis development.
Results
With a median follow-up of 18.7 months (range, 1.2 to 73.3 months), brain metastasis occurred in 18 of 138 patients (13.0%). In multivariate analysis, non-responders to durvalumab (odds ratio [OR], 4.86; 95% confidence interval [CI], 1.69 to 13.96; p=0.003) and initial supraclavicular nodal (SCN) involvement (OR, 2.89; 95% CI, 0.99 to 8.48; p=0.05) were independent predictors of brain metastasis. Non-responders demonstrated accelerated central nervous system (CNS) progression, with 63.6% developing brain metastases within 6 months versus 28.6% in responders. Programmed cell death ligand 1 ≥ 50% was associated with improved overall survival but not with brain metastasis incidence. All patients who developed brain metastases were epidermal growth factor receptor/anaplastic lymphoma kinase wild-type.
Conclusion
Non-responders to durvalumab and SCN involvement were significant predictors of brain metastasis in NSCLC treated with CCRT followed by durvalumab. These findings support risk-adapted CNS surveillance strategies in high-risk patients.

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Gynecologic cancer

Programmed Death-Ligand 1 Expression across Multiple Assays in Ovarian Cancer: A Comparative Analysis: Eun Bi Jang, Kyeong A So, Wook Youn Kim, So Dug Lim, Tae Jin Kim, Heejin Bang, Wan Seop Kim; Cancer Res Treat. 2026;58(2):622-631. Published online June 9, 2025; DOI: https://doi.org/10.4143/crt.2025.202

Abstract PDF Supplementary Material PubReader ePub: Purpose
Ovarian cancer presents significant treatment challenges due to its aggressive nature and poor response to immune checkpoint inhibitors (ICIs). The lack of standardized programmed cell death-ligand 1 (PD-L1) assays and cut-off values complicates clinical decision-making. We evaluated the concordance among commonly used PD-L1 assays and assessed changes in the expression of PD-L1 following chemotherapy.
Materials and Methods
Tissue samples from 29 patients with ovarian cancer were analyzed using five validated PD-L1 immunohistochemistry assays: Dako 22C3, Ventana SP263, Ventana SP142, Dako 28-8, and Ventana 22C3. PD-L1 positivity was assessed using a combined positive score (CPS), immune cell, or tumor proportion score at 1%, 5%, and 10% cut-offs. Concordance rates, including overall percent agreement and Cohen’s kappa coefficient, were analyzed. In addition, changes in the expression of PD-L1 pre- and postchemotherapy were evaluated.
Results
Positivity rates ranged from 15.8% (SP142) to 29.8% (Dako 22C3 and SP263) at the 1% CPS cut-off. SP142 consistently exhibited the lowest concordance, whereas Dako 22C3 displayed high agreement with SP263, 28-8, and Ventana 22C3. Chemotherapy increased PD-L1 positivity, with 28% of patients converting from negative to positive.
Conclusion
The expression of PD-L1 in ovarian cancer varies across assays and scoring methods, emphasizing the need for standardized testing protocols. Increased PD-L1 expression post-chemotherapy underscores the importance of assessing its status at appropriate times to guide ICI therapy. Larger studies are required to validate these findings and refine clinical applications.

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PD-L1 Testing in Gastric Cancer by the Combined Positive Score of the 22C3 PharmDx and SP263 Assay with Clinically Relevant Cut-offs: Yujun Park, Jiwon Koh, Hee Young Na, Yoonjin Kwak, Keun-Wook Lee, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim, Hye Seung Lee; Cancer Res Treat. 2020;52(3):661-670. Published online January 10, 2020; DOI: https://doi.org/10.4143/crt.2019.718

Abstract PDF Supplementary Material PubReader ePub

Purpose
We provide a comparison between 22C3 pharmDx and SP263 assay, for evaluating programmed death ligand 1 (PD-L1) expression in advanced gastric cancer (GC) patients.
Materials and Methods
The PD-L1 immunohistochemistry by 22C3 pharmDx and SP263 assays was performed in the center of the tumor (CT) and invasive margin (IM) in 379 GC tissues using tissue microarrays and interpreted as combined positive score (CPS) and tumor proportion score (TPS). Of the total samples, 55 samples were independently reviewed by five pathologists.
Results
The two assays showed a high correlation in both the CPS and TPS. At a CPS ≥ 1 cut-off, 219 (57.8%) and 231 (60.9%) GCs were positive for PD-L1 with the 22C3 and SP263 assays, and at ≥ 10 cut-off, 37 (9.8%) and 36 (9.5%) GCs were positive, respectively. The overall percent agreement (OPA) was greater than 90% with CPS ≥ 1 and ≥ 10 cut-offs, and TPS ≥ 1% and ≥ 10% cut-offs. There was higher OPA between the two assays with a CPS cut-off ≥ 10 (99.2%) than ≥ 1 (94.7%). The percent agreement between the CT and IM was higher with a CPS cut-off ≥ 10 (92.9%) than ≥ 1 (77.6%). Patient with positive expression at CPS ≥ 5 cut-off had a significantly better outcomes in both assays. Interobserver variability among five pathologists was higher than the assay variability.
Conclusion
Two assays for PD-L1 expression in GC showed high agreement. These results provide guidance for selecting eligible patients with GC for pembrolizumab treatment.

Citations

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