Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.
J Cancer Res Clin Oncol. 2021 Dec;147(12):3749-3755. doi: 10.1007/s00432-021-03615-5. Epub 2021 Mar 29.
The programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) in tumor tissue samples is an established clinical biomarker for non-small cell lung cancer (NSCLC). However, the significance of PD-L1 expression in other types of samples has not been fully investigated.
We conducted a multicenter retrospective cohort study of advanced NSCLC patients who received ICI treatment during the clinical course and investigated the effects of ICIs according to PD-L1 expression in cytology samples, including cell block and endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) samples.
A total of 264 patients were included in this study: PD-L1 expression was determined in cell block or TBNA specimens in 55 patients, and in tissue samples in 209 patients. Among the former patients, the median progression-free survival (PFS) of those with a TPS for PD-L1 ≥ 50% was significantly longer compared to that of those with a TPS < 50% (6.5 vs. 1.9 months, respectively, p = 0.008). When the cutoff value was set at 1%, the median PFS was 4.2 months in patients with a TPS ≥ 1% and 1.5 months in patients with a TPS < 1% (p < 0.001).
PD-L1 expression determined using cytology specimens predicts the efficacy of ICIs.
肿瘤组织样本中的程序性死亡配体 1（PD-L1）肿瘤比例评分（TPS）是一种已确立的非小细胞肺癌（NSCLC）临床生物标志物。然而，PD-L1 在其他类型样本中的表达意义尚未得到充分研究。
我们对接受ICI 治疗的晚期 NSCLC 患者进行了一项多中心回顾性队列研究，并根据细胞学样本中 PD-L1 表达（包括细胞块和支气管内超声引导（EBUS）经支气管针吸活检（TBNA）样本）研究了 ICI 的作用。
本研究共纳入 264 例患者：55 例患者的细胞块或 TBNA 标本中检测到 PD-L1 表达，209 例患者的组织样本中检测到 PD-L1 表达。在前一类患者中，PD-L1 TPS≥50%的患者中位无进展生存期（PFS）明显长于 PD-L1 TPS<50%的患者（分别为 6.5 个月和 1.9 个月，p=0.008）。当截断值设定为 1%时，PD-L1 TPS≥1%的患者中位 PFS 为 4.2 个月，PD-L1 TPS<1%的患者中位 PFS 为 1.5 个月（p<0.001）。
细胞学标本中 PD-L1 的表达预测了 ICI 的疗效。
