免疫检查点抑制剂治疗的非小细胞肺癌患者细胞学样本中 PD-L1 表达的意义。
Significance of PD-L1 expression in the cytological samples of non-small cell lung cancer patients treated with immune checkpoint inhibitors.
机构信息
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.
出版信息
J Cancer Res Clin Oncol. 2021 Dec;147(12):3749-3755. doi: 10.1007/s00432-021-03615-5. Epub 2021 Mar 29.
OBJECTIVES
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.
PATIENTS AND METHODS
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.
RESULTS
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).
CONCLUSION
PD-L1 expression determined using cytology specimens predicts the efficacy of ICIs.
目的
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。
患者和方法
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。
结果
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）。
结论
细胞学标本中 PD-L1 的表达预测了 ICI 的疗效。
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