Evidence map›Paper›PMID 41764558›Full record

Observational studyJournal of translational medicine2026

Baseline PD-L1 expression on circulating immune cells as a predictor of survival and immune-related adverse events in extensive-stage small-cell lung cancer patients treated with durvalumab and carboplatin-etoposide (NCT04712903 Trial).

Aida Piedra, Albert Guinart-Cuadra, Sergio Martínez-Recio, Maria Mulet, Carlos Zamora, Rubén Osuna-Gómez, Elisabet Cantó, Maria Angels Ortiz, José Alejandre, Andrés Barba and 10 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Journal of translational medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04712903 (A Phase IIIB, Single Arm Study, of Durvalumab in Combination With Platinum-Etoposide for Untreated Patients With Extensive-Stage Small Cell Lung Cancer Reflecting Real World Clinical Practice in Spain), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04712903 phase3completednot on this map

A Phase IIIB, Single Arm Study, of Durvalumab in Combination With Platinum-Etoposide for Untreated Patients With Extensive-Stage Small Cell Lung Cancer Reflecting Real World Clinical Practice in Spain (CANTABRICO).

TypeinterventionalSponsorAstraZenecaRan2020 to 2023Enrolled101ConditionsSmall Cell Lung Carcinoma Extensive DiseaseArmsDurvalumab, Cisplatin, Etoposide, Carboplatin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Aida Piedra *Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain.ORCID 0000-0002-4795-1132
Albert Guinart-Cuadra *Inflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0003-0233-5595
Sergio Martínez-RecioMedical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain.ORCID 0000-0001-8056-7100
Maria MuletInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0003-3639-3291
Carlos ZamoraInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0003-2962-678X
Rubén Osuna-GómezInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0003-2875-4405
Elisabet CantóInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0002-1782-1855
Maria Angels OrtizInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.ORCID 0000-0002-1574-9861
José AlejandreInflammatory Diseases, Institut de Recerca Sant Pau (IR SANT PAU), Sant Qunití 77-79, Barcelona, 08041, Spain.
Andrés BarbaMedical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain.ORCID 0000-0003-2500-0253
Judit Sanz-BeltránMedical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain.ORCID 0000-0001-7526-4973
Jorgina Serra-LópezMedical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain.ORCID 0000-0002-2363-7149
Dolores IslaMedical Oncology Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain.ORCID 0000-0002-2483-198X
Edurne ArriolaMedical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain.ORCID 0000-0001-8960-7519
Luis Paz-AresMedical Oncology Department, Hospital Universitario 12 Octubre, Madrid, Spain.
María Pilar Diz-TaínMedical Oncology Department, Complejo Asistencial Universitario de León, León, Spain.
Alberto Luis MorenoMedical Oncology Department, Hospital Universitario Reina Sofía, Córdoba, Spain.ORCID 0000-0002-4063-7773
Ángel CallejoAstraZeneca Farmacéutica Spain, Madrid, Spain.ORCID 0009-0004-1656-4019
Silvia Vidal *Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Margarita Majem *Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, 08025, Spain. mmajem@santpau.cat.ORCID 0000-0002-9919-7485

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite improved efficacy with first-line immune checkpoint inhibitors plus platinum-based chemotherapy for extensive-stage small cell lung cancer (ES-SCLC), long-term survival remains limited. There is currently no available predictive biomarker to identify which patients would benefit most from this treatment. We hypothesized that pre-treatment PD-L1 expression on circulating immune cells might predict survival outcomes and toxicity. MATERIAL AND

methodsThis prospective, multi-center observational study included patients with untreated ES-SCLC treated with first-line durvalumab plus platinum-based chemotherapy. The percentages of circulating PD-L1+ immune cells at baseline were analysed by flow cytometry to assess their association with survival outcomes and the development of immune-related adverse events (irAEs).

resultsAmong 41 patients with ES-SCLC, 65.9% were male, 73.2% had an ECOG-PS 1, 9.8% had central nervous system (CNS) metastases and 31.7% had liver metastases. Sixteen patients (39%) experienced irAEs. Median PFS was longer in patients with high percentages of circulating PD-L1+ monocytes compared to those with low percentages: 8.97 months (95% CI NR to NR) vs. 5.97 months (95% CI 4.65 to 7.28), p = 0.007. There was a trend toward longer median OS in patients with ES-SCLC and high percentages of circulating PD-L1+ monocytes versus low percentages: NR (95% CI NR-NR) vs. 9.13 months (95% CI 6.34 to 11.92), p = 0.092. Patients with higher circulating PD-L1+ neutrophils correlated with the development of irAES (p = 0.007).

conclusionsOur results showed a statistically significant longer PFS in patients with ES-SCLC and high percentages of circulating PD-L1+ monocytes. This suggests PD-L1 expression on monocytes might be established as a predictive biomarker for patients with ES-SCLC treated with upfront chemo-immunotherapy.

trial registrationNCT04712903 Trial. Last registered 1 December 2025, https://www.clinicaltrials.gov/study/NCT04712903 .

Indexed as

Antibodies, MonoclonalAntineoplastic Combined Chemotherapy ProtocolsB7-H1 AntigenCarboplatinEtoposideLung NeoplasmsSmall Cell Lung CarcinomaAgedFemaleHumansMaleMiddle AgedNeoplasm StagingAntibodies, MonoclonalB7-H1 AntigenCarboplatinCD274 protein, humandurvalumabEtoposideCirculating immune cellsCirculating PD-L1+ monocytesCirculating PD-L1+ neutrophilsExtensive stage small-cell lung cancer (ES-SCLC)ImmunotherapyPredictive biomarker

Identifiers

PMID41764558
PMCPMC13059145

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.