Clinical implications of CD47 and programmed death-ligand 1 expression in predicting the therapeutic response of immune checkpoints in advanced nonsmall-cell lung cancer.
This study aimed to evaluate CD47 expression in nonsmall-cell lung cancer (NSCLC) and explore the predictive value of combined CD47 and programmed death-ligand 1 (PD-L1) status for immunotherapy outcomes.
Specimens from 59 patients with advanced NSCLC who were diagnosed or surgically resected and subsequently received immune checkpoint inhibitors (ICIs) were retrospectively collected for CD47 and PD-L1 detection by immunohistochemistry (IHC) and multiplex fluorescent IHC. A receiver operating characteristic (ROC) curve was constructed to determine the optimal CD47 cutoff value, and patients were categorized into four groups based on the IHC results: low CD47/negative-low PD-L1, high CD47/negative-low PD-L1, low CD47/high PD-L1, and high CD47/high PD-L1. In addition, the correlation between marker expression and clinical outcomes was analyzed.
CD47 positivity was observed in 53 cases, 29 (54.7%) of which showed the coexpression of PD-L1/CD47. ROC analysis defined the threshold for high CD47 expression as >38.9% stained tumor cells. Multivariate analysis identified CD47 and PD-L1 as independent prognostic factors for immunotherapy efficacy (CD47: PFS P = 0.003, OS P = 0.001; PD-L1: PFS P = 0.424, OS P = 0.004). Subgroup analysis revealed that the low CD47/high PD-L1 group had the longest progression-free survival (PFS), not reaching the median, whereas the high CD47/negative-low PD-L1 group had the shortest PFS (median 131 days). Moreover, high CD47 expression was negatively correlated with PFS regardless of PD-L1 level.
The combined assessment of CD47 and PD-L1 performed excellently in predicting responses to ICIs in advanced NSCLC, and this approach may serve as a potential predictive biomarker for immunotherapy.
Specimens from 59 patients with advanced NSCLC who were diagnosed or surgically resected and subsequently received immune checkpoint inhibitors (ICIs) were retrospectively collected for CD47 and PD-L1 detection by immunohistochemistry (IHC) and multiplex fluorescent IHC. A receiver operating characteristic (ROC) curve was constructed to determine the optimal CD47 cutoff value, and patients were categorized into four groups based on the IHC results: low CD47/negative-low PD-L1, high CD47/negative-low PD-L1, low CD47/high PD-L1, and high CD47/high PD-L1. In addition, the correlation between marker expression and clinical outcomes was analyzed.
CD47 positivity was observed in 53 cases, 29 (54.7%) of which showed the coexpression of PD-L1/CD47. ROC analysis defined the threshold for high CD47 expression as >38.9% stained tumor cells. Multivariate analysis identified CD47 and PD-L1 as independent prognostic factors for immunotherapy efficacy (CD47: PFS P = 0.003, OS P = 0.001; PD-L1: PFS P = 0.424, OS P = 0.004). Subgroup analysis revealed that the low CD47/high PD-L1 group had the longest progression-free survival (PFS), not reaching the median, whereas the high CD47/negative-low PD-L1 group had the shortest PFS (median 131 days). Moreover, high CD47 expression was negatively correlated with PFS regardless of PD-L1 level.
The combined assessment of CD47 and PD-L1 performed excellently in predicting responses to ICIs in advanced NSCLC, and this approach may serve as a potential predictive biomarker for immunotherapy.