Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
Jpn J Clin Oncol. 2020 May 5;50(5):617-622. doi: 10.1093/jjco/hyaa033.
Epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer is less likely to express programmed death-ligand 1 (PD-L1) than tumors with wild-type EGFR and is associated with poor response to pembrolizumab. To understand the relationship between EGFR mutation and PD-L1 expression in pembrolizumab response, we retrospectively evaluated the factors contributing to the high tumor proportion score in 155 EGFR-mutant non-small cell lung cancer cases and their associated response to pembrolizumab. Uncommon EGFR mutations were significantly associated with a PD-L1 tumor proportion score ≥ 50% compared to common EGFR mutations. The objective response rate to pembrolizumab of 14 patients was 36%, including 22% in patients with common EGFR mutations, 60% in patients with uncommon EGFR mutations and 75% in patients with both uncommon mutations and a PD-L1 tumor proportion score ≥ 50%. A PD-L1 tumor proportion score ≥ 50% was more frequent in non-small cell lung cancer patients harboring uncommon EGFR mutations and was associated with pembrolizumab efficacy.
表皮生长因子受体（EGFR）突变型非小细胞肺癌比野生型 EGFR 肿瘤表达程序性死亡配体 1（PD-L1）的可能性更低，并且与对 pembrolizumab 的反应不良相关。为了了解 EGFR 突变与 pembrolizumab 反应中 PD-L1 表达之间的关系，我们回顾性评估了 155 例 EGFR 突变型非小细胞肺癌病例中导致高肿瘤比例评分的因素及其与 pembrolizumab 反应的相关性。与常见的 EGFR 突变相比，罕见的 EGFR 突变与 PD-L1 肿瘤比例评分≥50%显著相关。14 名患者对 pembrolizumab 的客观缓解率为 36%，其中常见 EGFR 突变患者为 22%，罕见 EGFR 突变患者为 60%，同时具有罕见突变和 PD-L1 肿瘤比例评分≥50%的患者为 75%。罕见 EGFR 突变的非小细胞肺癌患者中 PD-L1 肿瘤比例评分≥50%更为常见，并且与 pembrolizumab 的疗效相关。
