2026-10-14T08:08:47Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33871138 2026-09-17T04:46:19Z category_388 portal_316 item_type_3 month_year_09_2026

Table 1_Microsatellite instability combined with PD-L1 expression in prognosis of gastric cancer: an integrated analysis based on individual patient data.docx Yajing Feng (7532729) Mengmeng Yin (4381234) Junhui Chai (11780078) Jicun Zhu (7335014) Yuehua Zhang (541836) Kaijuan Wang (6104744) Fujiao Duan (561366) Oncology and Carcinogenesis not elsewhere classified gastric cancer immunotherapy meta-analysis microsatellite instability PD-L1 prognosis Objective<p>This study aimed to systematically assess the predictive value of microsatellite instability (MSI) combined with programmed death-ligand 1 (PD-L1) expression for prognosis and immunotherapy response in patients with gastric cancer (GC).</p>Methods<p>An individual patient data (IPD) meta-analysis was performed in accordance with the PICOS framework and PRISMA 2020 guidelines. A comprehensive literature search was performed across English and Chinese databases to identify cohort studies or randomized controlled trials (RCTs) that simultaneously evaluated MSI status and PD-L1 expression, and reported overall survival (OS), disease-free survival (DFS) with 95% confidence intervals (CIs) were used as pooled effect measures. Fixed-effect or random-effects models were applied based on heterogeneity assessed by the I² statistic. Subgroup analyses were stratified by ethnicity, pathological stage, Lauren classification, chemotherapy timing, MSI detection platform, and PD-L1 antibody clone. The interactive effect of MSI-H and PD-L1 expression was evaluated using radar plots.</p>Results<p>Nine studies involving 6,667 GC patients were included. For OS, MSI-H alone (HR = 0.500, 95%CI: 0.357-0.700, P < 0.001), and MSI-H/MSI-L combined (HR = 0.641, 95%CI: 0.437-0.939, P = 0.025) were associated with better outcomes than MSS; PD-L1 positivity predicted poorer OS (HR = 1.517, 95%CI: 1.077-2.137, P = 0.017); MSI-H+PD-L1 negative patients had the most favorable OS (HR = 0.380, 95%CI: 0.255-0.566, P < 0.001), while MSI-H+PD-L1 positive patients had poorer OS than MSS+PD-L1 negative patients (HR = 2.076, 95%CI: 1.238-3.479, P = 0.006). For DFS, MSI-H alone (HR = 0.506, 95%CI: 0.360-0.710, P < 0.001) and MSI-H/MSI-L combined (HR = 0.530, 95%CI: 0.402-0.698, P < 0.001) outperformed MSS, but PD-L1 expression showed no significant DFS association (HR = 1.189, 95%CI: 0.472-2.998, P = 0.709). Subgroup analyses identified TNM stage, Lauren classification, chemotherapy timing, and MSI detection method as significant effect modifiers (all interaction P < 0.05). Pooled immunotherapy data showed that MSI-H patients had higher ORR than MSS (OR = 3.580, P < 0.001), and MSI-H+PD-L1 positive patients achieved the highest response rates (OR = 4.100 vs. MSI-H+PD-L1 negative, P < 0.001). Sensitivity analysis confirmed result stability, and publication bias was minimal.</p>Conclusion<p>MSI-H status is a robust favorable prognostic factor for GC, while PD-L1 positivity indicates adverse OS prognosis. The combination of MSI and PD-L1 expression enables refined prognostic stratification of GC patients.</p> 2026-09-17T04:46:19Z Dataset Dataset 10.3389/fonc.2026.1900024.s001 https://figshare.com/articles/dataset/Table_1_Microsatellite_instability_combined_with_PD-L1_expression_in_prognosis_of_gastric_cancer_an_integrated_analysis_based_on_individual_patient_data_docx/33871138 CC BY 4.0