Neoplasma. 2018;65(1):140-146. doi: 10.4149/neo_2018_170206N77.
Inoperable locally advanced non-small cell lung cancer (LA NSCLC) is treated with concurrent or sequential chemotherapy (ChT) and radiation therapy (RT). Survival rates with this treatment remains poor, reported 5-year survival is about 15%. New treatment strategies, including immunotherapy with programmed death ligand-1 (PD-L1) check point inhibitors are being investigated. The clinical significance of PD-L1 expression in tumor samples from patients with inoperable LA NSCLC who underwent concurrent chemoradiotherapy (CRT) in our institution between 2005 and 2010 was evaluated. The expression of PD-L1 was correlated with clinical and pathological parameters and outcome of treatment. We analysed 107 patients treated with concurrent CRT. Only 43 patients (36 males and 7 females) had sufficient tissue for immunohistochemical (IHC) staining. PD-L1 expression was demonstrated in 7 tumors. No statistical significant differences in patient characteristics, including age, smoking status and gender, were found according to the PD-L1 expression. After a median follow up of 103.6 months, median progression free survival (PFS) was 19.9 months in patients without and 10.1 months in patients with PD-L1 expression (p=0.006). Median overall survival (OS) was 28.4 and 12.1 months for PD-L1 negative and PD-L1 positive patients, respectively (p=0.012).In conclusions, PD-L1 expression was negative prognostic factor for PFS and OS after concurrent CRT in LA NSCLC. As only small number of patients had enough tissue for the IHC testing, no firm conclusions could be made and further investigation is warranted.
局部晚期不可手术非小细胞肺癌（LA NSCLC）采用同步或序贯化疗（ChT）和放射治疗（RT）治疗。这种治疗的存活率仍然很低，报告的 5 年存活率约为 15%。正在研究新的治疗策略，包括程序性死亡配体-1（PD-L1）检查点抑制剂的免疫疗法。评估了 2005 年至 2010 年间在我们机构接受同步放化疗（CRT）的不可手术 LA NSCLC 患者肿瘤样本中 PD-L1 表达的临床意义。分析了 107 例接受同步 CRT 治疗的患者。只有 43 例（36 名男性和 7 名女性）有足够的组织进行免疫组织化学（IHC）染色。在 7 个肿瘤中显示出 PD-L1 表达。根据 PD-L1 表达，未发现患者特征（包括年龄、吸烟状况和性别）存在统计学显着差异。中位随访 103.6 个月后，PD-L1 表达阴性患者的无进展生存期（PFS）为 19.9 个月，PD-L1 表达阳性患者为 10.1 个月（p=0.006）。PD-L1 阴性和 PD-L1 阳性患者的总生存期（OS）分别为 28.4 个月和 12.1 个月（p=0.012）。总之，PD-L1 表达是 LA NSCLC 同步 CRT 后 PFS 和 OS 的预后不良因素。由于只有少数患者有足够的组织进行 IHC 检测，因此无法得出明确的结论，需要进一步研究。
