ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Image-based PD-L1 scoring and tumor-infiltrating lymphocytes as predictors for the response to neoadjuvant chemoimmunotherapy in non-small cell lung cancer.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Baseline Neutrophil-to-Lymphocyte Ratio and Two-Year Incident Distant Metastasis in Stage I-III Lung Cancer: A Single-Center Retrospective Cohort Study.Journal of clinical medicine · 2026Article
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8 authors.
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Abstract
purposeTo investigate the predictive performance of PD-L1 expression and tumor-infiltrating lymphocytes (TILs) in pre-treatment biopsies for the response to neoadjuvant chemoimmunotherapy in non-small cell lung cancer (NSCLC).
methodsThis retrospective study included 82 NSCLC patients who received neoadjuvant chemoimmunotherapy. PD-L1 expression (tumor cell [TC%], immune cell [IC%], and combined positive score [CPS]), TILs density, and the lymphocyte-to-tumor ratio (LTR) were quantitatively assessed using digital image analysis (IA). Diagnostic performance was evaluated for major pathological response (MPR), pathological complete response (pCR), and event-free survival (EFS).
resultsOf the 82 patients, 48 (58.5%) achieved MPR and 25 (30.5%) achieved pCR. TC%-IA and TILs density were significantly associated with pathological response. For predicting MPR, TC%-IA (AUC = 0.67) showed better performance than IC%-IA (AUC = 0.61) and CPS-IA (AUC = 0.66). Similarly, for pCR, TC%-IA (AUC = 0.59) outperformed IC%-IA (AUC = 0.55) and CPS-IA (AUC = 0.47). TILs density yielded AUCs of 0.70 for MPR and 0.69 for pCR, while LTR-IA achieved AUCs of 0.71 and 0.61, respectively. The combination of TC%-IA ≥ 1% and LTR-IA ≥ 1 further improved predictive performance, with AUCs of 0.76 for MPR and 0.67 for pCR. Prognostic analysis showed that TC%-IA ≥ 1%, CPS-IA ≥ 10, and LTR-IA ≥ 1 were significantly associated with prolonged EFS.
conclusionsImage-based PD-L1 scoring on TC% combined with LTR ≥ 1 serves as a predictive biomarker for both pathological response and EFS in NSCLC patients receiving neoadjuvant chemoimmunotherapy. LTR can serve as a surrogate for TILs scoring and predicts long-term EFS.
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