Kobayashi Kenichi, Seike Masahiro, Zou Fenfei, Noro Rintaro, Chiba Mika, Ishikawa Arimi, Kunugi Shinobu, Kubota Kaoru, Gemma Akihiko
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
Anticancer Res. 2018 Feb;38(2):753-762. doi: 10.21873/anticanres.12281.
BACKGROUND/AIM: Recent clinical trials have shown that immune checkpoint blockades that target either PD-1 or PD-L1 yield remarkable responses in a subgroup of patients with non-small cell lung cancer (NSCLC).
We retrospectively examined, by immunohistochemical analysis, 211 NSCLC samples. Using 32 independent samples, we also evaluated PD-L1 expression in NSCLC patients with EGFR gene mutations treated by EGFR-TKIs.
Overall survival of PD-L1-positive stages I-III NSCLC and stage I NSCLC and stages I-III squamous cell carcinoma (SQ) were significantly shorter than those of PD-L1-negative NSCLC (p<0.01 and p=0.02 and p=0.01, respectively). In stage I NSCLC and stages I-III SQ, PD-L1 expression was found to be independent predictor of death after multivariate analysis. Response to EGFR-TKIs was not significantly different between PD-L1-positive and PD-L1-negative NSCLC patients with EGFR mutations.
PD-L1 expression was a significant independent predictor of poor outcome in NSCLC patients.
背景/目的：近期临床试验表明，针对程序性死亡受体1（PD-1）或程序性死亡配体1（PD-L1）的免疫检查点阻断疗法在部分非小细胞肺癌（NSCLC）患者中产生了显著疗效。
我们通过免疫组化分析对211例NSCLC样本进行了回顾性研究。利用32个独立样本，我们还评估了接受表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗的EGFR基因突变NSCLC患者的PD-L1表达情况。
PD-L1阳性的Ⅰ-Ⅲ期NSCLC、Ⅰ期NSCLC以及Ⅰ-Ⅲ期鳞状细胞癌（SQ）的总生存期显著短于PD-L1阴性的NSCLC（分别为p<0.01、p=0.02和p=0.01）。在Ⅰ期NSCLC和Ⅰ-Ⅲ期SQ中，多因素分析发现PD-L1表达是死亡的独立预测因素。EGFR基因突变的NSCLC患者中，PD-L1阳性和阴性患者对EGFR-TKIs的反应无显著差异。
PD-L1表达是NSCLC患者预后不良的重要独立预测因素。
