Cancer Res Treat.  2018 Jan;50(1):95-102. 10.4143/crt.2016.591.

Retrospective Molecular Epidemiology Study of PD-L1 Expression in Patients with EGFR-Mutant Non-small Cell Lung Cancer

Affiliations
  • 1Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhingookkim@gmail.com
  • 2Merck & Co., Inc., Kenilworth, NJ, USA.
  • 3Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Data are limited on programmed death ligand 1 (PD-L1) expression in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
We retrospectively evaluated the relationship between PD-L1 expression and recurrence-free survival (RFS) and overall survival in 319 patients with EGFR-mutant NSCLC who were treated at Samsung Medical Center from 2006 to 2014. Membranous PD-L1 expression on tumor cells was measured using the PD-L1 IHC 22C3 pharmDx antibody and reported as tumor proportion score (TPS). Kaplan-Meier methods, log-rank test, and Cox proportional hazards models were used for survival analysis.
RESULTS
All patients had ≥1 EGFR mutation"”54% in exon 19 and 39% in exon 21. Overall, 51% of patients had PD-L1-positive tumors. The prevalence of PD-L1 positivity was higher among patients with stages II-IV versus stage I disease (64% vs. 44%) and among patients with other EGFR mutations (75%) than with L858R mutation (39%) or exon 19 deletion (52%). PD-L1 positivity was associated with shorter RFS, with an adjusted hazard ratio of 1.52 (95% confidence interval [CI], 0.81 to 2.84; median, 18 months) for the PD-L1 TPS ≥ 50% group, 1.51 (95% CI, 1.02 to 2.21; median, 31 months) for the PD-L1 TPS 1%-49% group, and 1.51 (95% CI, 1.05 to 2.18) for the combined PD-L1-positive groups (TPS ≥ 1%) compared with the PD-L1-negative group (median, 35 months).
CONCLUSION
PD-L1 expression is associated with disease stage and type of EGFR mutation. PD-L1 positivity might be associated with worse RFS among patients with surgically treated EGFR-mutant NSCLC.

Keyword

Programmed cell death 1 protein; Epidermal growth factor receptor; Non-small cell lung carcinoma

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Exons
Humans
Molecular Epidemiology*
Prevalence
Programmed Cell Death 1 Receptor
Proportional Hazards Models
Receptor, Epidermal Growth Factor
Retrospective Studies*
Programmed Cell Death 1 Receptor
Receptor, Epidermal Growth Factor

Figure

  • Fig. 1. Sample images of programmed death ligand 1 (PD-L1) staining in non-small cell lung cancer. (A) PD-L1 negative (tumor proportion score [TPS] < 1%). (B) PD-L1 TPS 1%-49%. (C) PD-L1 TPS ≥ 50%. All images are at original magnification ×20, blue counterstain is hematoxylin, and PD-L1 is identified by brown chromagen.

  • Fig. 2. Recurrence-free survival among patients with nonsmall cell lung cancer and epidermal growth factor receptor mutation, by programmed death ligand 1 status. TPS, tumor proportion score.

  • Fig. 3. Overall survival among patients with non-small cell lung cancer and epidermal growth factor receptor mutation, by programmed death ligand 1 status. TPS, tumor proportion score.


Reference

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