PD-L1 expression and its effect on clinical outcomes of EGFR-mutant NSCLC patients treated with EGFR-TKIs

被引:25
作者
Bai, Yuchen [1 ,2 ]
Chen, Xiaoxia [3 ]
Hou, Likun [4 ,5 ]
Qian, Jun [6 ]
Jiang, Tao [3 ]
Zhou, Caicun [3 ]
Ciebiada, Maciej [1 ]
机构
[1] Med Univ Lodz, Univ Clin Hosp Norbert Barlicki, Dept Gen & Oncol Pulmonol, PL-50243 Lodz, Poland
[2] Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Urol, Sch Med, Shanghai 200011, Peoples R China
[3] Tongji Univ, Sch Med, Dept Med Oncol, Shanghai 200433, Peoples R China
[4] Tongji Univ, Sch Med, Shanghai Pulm Hosp, Dept Pathol, Shanghai 200433, Peoples R China
[5] Tongji Univ, Sch Med, Thorac Canc Inst, Shanghai 200433, Peoples R China
[6] Nanjing Med Univ, Affiliated Suzhou Hosp, Suzhou Canc Ctr, Dept Med Oncol, Suzhou 215000, Peoples R China
基金
中国国家自然科学基金;
关键词
CELL LUNG-CANCER; LIGAND; EXPRESSION; OPEN-LABEL; 1ST-LINE TREATMENT; PROGNOSTIC-SIGNIFICANCE; MUTATIONS; CHEMOTHERAPY; ASSOCIATION; MULTICENTER; DOCETAXEL;
D O I
10.20892/j.issn.2095-3941.2018.0223
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: Epidermal growth factor receptor (EGFR) activation was reported to upregulate programmed death-ligand 1 (PD-L1) expression in lung cancer cells and subsequently contribute to immune escape, indicating its critical role in EGFR-driven lung tumors. This study characterized PD-L1 expression in patients with surgically resected EGFR-mutant non-small cell lung cancer (NSCLC). The effect of PD-L1 expression on clinical outcomes was also investigated in advanced EGFR-mutant NSCLC treated with EGFR-tyrosine kinase inhibitors (TKIs). Methods: In total, 73 patients with surgically resected NSCLC and EGFR mutations were identified. PD-L1 expression and CD8+ tumor-infiltrating lymphocyte (TIL) density were assessed by immunohistochemistry. A literature review of publications that assessed the predictive and prognostic value of PD-L1 expression in advanced EGFR-mutant NSCLC patients treated with EGFR-TKIs was performed. Results: Nineteen (26.0%) patients were positive for PD-L1 expression, which was significantly associated with concomitant KRAS mutation (P = 0.020) and marginally associated with higher CD8+ TILs density (P = 0.056). Positive PD-L1 expression was associated with markedly inferior overall survival (OS) in multivariate analysis (P = 0.032). The combination of PD-L1 and CD8+ TILs expression could be used to stratify the population into three groups with distinct prognoses. A meta-analysis of six publications showed that positive PD-L1 expression was not associated with OS [hazard ratio (HR) = 0.90; 95% confidence interval (CI), 0.42-1.38] or progression-free survival (HR = 1.03; 95 CI, 0.73-1.33) in advanced EGFR-mutant NSCLC patients receiving EGFR-TKIs. Conclusions: PD-L1 expression tended to correlate with CD8+ TIL expression, concomitant KRAS mutation, and poor survival in surgically resected EGFR-mutant NSCLC. PD-L1 expression was neither the predictive nor the prognostic factor in advanced EGFR-mutant NSCLC patients treated with EGFR-TKIs.
引用
收藏
页码:434 / +
页数:12
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