Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Cancer. 2020 Jun;132:150-158. doi: 10.1016/j.ejca.2020.03.029. Epub 2020 May 1.
We evaluated programmed death ligand 1 (PD-L1) expression and efficacy of PD-1/PD-L1 inhibitors in patients with pulmonary pleomorphic carcinoma (PC).
We created two cohorts of patients diagnosed with pulmonary PC from 2016 to 2019, PD-L1 expression and programmed death 1 (PD-1)/PD-L1 inhibitor efficacy cohorts. The PD-L1 expression cohort included all patients evaluated for PD-L1 expression, irrespective of PD-1/PD-L1 inhibitor therapy. High PD-L1 expression was defined as ≥50% positive tumour cells (TC) for 22C3, ≥25% for SP263 or ≥10%/5% TC/immune cell (IC) for SP142. The PD-1/PD-L1 efficacy cohort included patients treated with PD-1/PD-L1 inhibitors, irrespective of PD-L1 tests.
One hundred twenty-five of 175 patients diagnosed with pulmonary PCs were included in the PD-L1 expression cohort. Among them, 112 patients (89.6%) had PD-L1-positive (≥1%) tumours and 100 (80.0%) had tumours with high PD-L1 expression. A total of 49 patients were included in the efficacy cohort: 40 received pembrolizumab, 7 nivolumab and 2 atezolizumab. The objective response rate was 49.0%, with a median progression-free survival (PFS) of 7.2 months and a median overall survival of 22.2 months. In the efficacy cohort, high PD-L1 expression (n = 41) was associated with longer PFS (median: 7.2 versus 1.5 months, hazard ratio [HR]: 0.53 [0.22-1.29], p = 0.16) and overall survival (median: 22.2 versus 3.5, HR: 0.21 [0.08-0.57], p = 0.001) than low/negative/unknown PD-L1 expression (n = 8).
PD-1/PD-L1 inhibitors show outstanding efficacy for pulmonary PCs, and this is possibly attributable to high PD-L1 expression in these tumours.
我们评估了程序性死亡配体 1（PD-L1）在肺多形性癌（PC）患者中的表达和 PD-1/PD-L1 抑制剂的疗效。
我们从 2016 年至 2019 年创建了两个肺 PC 患者队列，即 PD-L1 表达和 PD-1/PD-L1 抑制剂疗效队列。PD-L1 表达队列纳入了所有接受 PD-L1 表达评估的患者，无论是否接受 PD-1/PD-L1 抑制剂治疗。高 PD-L1 表达定义为 22C3 阳性肿瘤细胞（TC）≥50%，SP263 阳性 TC≥25%或 SP142 的 TC/免疫细胞（IC）≥10%/5%。PD-1/PD-L1 疗效队列纳入了接受 PD-1/PD-L1 抑制剂治疗的患者，无论 PD-L1 检测结果如何。
175 例肺 PC 患者中有 125 例纳入 PD-L1 表达队列。其中，112 例（89.6%）患者肿瘤 PD-L1 阳性（≥1%），100 例（80.0%）患者肿瘤高 PD-L1 表达。疗效队列共纳入 49 例患者：40 例接受 pembrolizumab，7 例接受 nivolumab，2 例接受 atezolizumab。客观缓解率为 49.0%，中位无进展生存期（PFS）为 7.2 个月，中位总生存期为 22.2 个月。在疗效队列中，高 PD-L1 表达（n=41）与更长的 PFS（中位：7.2 个月与 1.5 个月，风险比[HR]：0.53[0.22-1.29]，p=0.16）和总生存期（中位：22.2 个月与 3.5 个月，HR：0.21[0.08-0.57]，p=0.001）相关，而低/阴性/未知 PD-L1 表达（n=8）患者的 PFS 和总生存期较短。
PD-1/PD-L1 抑制剂对肺多形性癌具有显著疗效，这可能与这些肿瘤中高 PD-L1 表达有关。
