Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Merck & Co., Inc., Kenilworth, NJ, USA.
Cancer Res Treat. 2018 Jan;50(1):95-102. doi: 10.4143/crt.2016.591. Epub 2017 Mar 17.
Data are limited on programmed death ligand 1 (PD-L1) expression in epidermal growth factor receptor ()-mutant non-small cell lung cancer (NSCLC).
We retrospectively evaluated the relationship between PD-L1 expression and recurrence-free survival (RFS) and overall survival in 319 patients with -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.
All patients had ≥1 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 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).
PD-L1 expression is associated with disease stage and type of mutation. PD-L1 positivity might be associated with worse RFS among patients with surgically treated -mutant NSCLC.
关于程序性死亡配体 1（PD-L1）在表皮生长因子受体（）突变型非小细胞肺癌（NSCLC）中的表达，数据有限。
我们回顾性评估了 319 例在 2006 年至 2014 年期间在三星医疗中心接受治疗的 -突变型 NSCLC 患者中 PD-L1 表达与无复发生存（RFS）和总生存之间的关系。使用 PD-L1 IHC 22C3 pharmDx 抗体测量肿瘤细胞上的膜 PD-L1 表达，并报告为肿瘤比例评分（TPS）。使用 Kaplan-Meier 方法、对数秩检验和 Cox 比例风险模型进行生存分析。
所有患者均有≥1 突变-54%在 19 外显子和 39%在 21 外显子。总体而言，51%的患者肿瘤呈 PD-L1 阳性。与 I 期疾病患者相比，II-IV 期疾病患者（64%比 44%）和具有其他 突变患者（75%）的 PD-L1 阳性率更高，而 L858R 突变患者（39%）或 19 外显子缺失患者（52%）的 PD-L1 阳性率更高。PD-L1 阳性与较短的 RFS 相关，对于 PD-L1 TPS≥50%组，调整后的风险比为 1.52（95%置信区间[CI]，0.81 至 2.84；中位数，18 个月），对于 PD-L1 TPS 1%-49%组，调整后的风险比为 1.51（95%CI，1.02 至 2.21；中位数，31 个月），对于联合 PD-L1 阳性组（TPS≥1%），与 PD-L1 阴性组（中位数，35 个月）相比。
PD-L1 表达与疾病分期和 突变类型有关。PD-L1 阳性可能与接受手术治疗的 -突变型 NSCLC 患者的 RFS 较差有关。
