Inomata Minehiko, Matsumoto Masahiro, Mizushima Isami, Seto Zenta, Hayashi Kana, Tokui Kotaro, Taka Chihiro, Okazawa Seisuke, Kambara Kenta, Imanishi Shingo, Miwa Toshiro, Hayashi Ryuji, Matsui Shoko, Tobe Kazuyuki
First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Department of Medical Oncology, Toyama University Hospital, Toyama, Japan.
Cancer Diagn Progn. 2022 May 3;2(3):324-329. doi: 10.21873/cdp.10112. eCollection 2022 May-Jun.
BACKGROUND/AIM: The association between tumor PD-L1 expression and the rate of acquisition of the T790M mutation during treatment with first-/second-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is a matter of study. This retrospective study was conducted to evaluate the association of tumor PD-L1 expression with the time on treatment under EGFR-TKIs in patients with EGFR-mutant non-small cell lung cancer (NSCLC), treated with first-/second-generation EGFR-TKIs.
We conducted a retrospective review of the medical charts of patients with EGFR-mutant NSCLC treated with first- /second-generation EGFR-TKIs. Time on treatment with EGFR-TKIs was defined as the sum of progression-free survival period (PFS) from the start of treatment with first- /second-generation EGFR-TKIs and the PFS from the start of osimertinib treatment after acquisition of the T790M mutation. Tumor PD-L1 expression was evaluated using the 22C3 antibody.
Data of a total of 49 patients were analyzed, including 20 patients with negative tumor PD-L1 expression (tumor proportion score <1%) and 29 patients with positive tumor PD-L1 expression (tumor proportion score ≥1%). In the negative tumor PD-L1 expression group, the T790M mutation was detected in 12 (75%) of the 16 patients. In the positive tumor PD-L1 expression group, the T790M mutation was detected 6 (31.6%) out of the 19 patients in whom it was tested. The median (95% confidence interval) time on treatment with EGFR-TKIs was 21.7 (12.9-24.8) months and 12.3 (5.6-22.2) months in the negative and positive tumor PD-L1 expression groups, respectively. Analysis using a Cox proportional hazards model identified performance status and presence/absence of tumor PD-L1 expression as significantly associated with the time on treatment with EGFR-TKIs.
EGFR-mutant NSCLC patients with negative tumor PD-L1 expression showed a higher rate of acquisition of the T790M mutation and implementation rate of osimertinib therapy, leading to a longer time on treatment with EGFR-TKI.
背景/目的：肿瘤程序性死亡受体配体1（PD-L1）表达与第一代/第二代表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗期间T790M突变获得率之间的关联是一个研究课题。本回顾性研究旨在评估在接受第一代/第二代EGFR-TKIs治疗的表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）患者中，肿瘤PD-L1表达与EGFR-TKIs治疗时间的关联。
我们对接受第一代/第二代EGFR-TKIs治疗的EGFR突变NSCLC患者的病历进行了回顾性分析。EGFR-TKIs治疗时间定义为从第一代/第二代EGFR-TKIs治疗开始的无进展生存期（PFS）与T790M突变获得后从奥希替尼治疗开始的PFS之和。使用22C3抗体评估肿瘤PD-L1表达。
共分析了49例患者的数据，包括20例肿瘤PD-L1表达阴性（肿瘤比例评分<1%）的患者和29例肿瘤PD-L1表达阳性（肿瘤比例评分≥1%）的患者。在肿瘤PD-L1表达阴性组中，16例患者中有12例（75%）检测到T790M突变。在肿瘤PD-L1表达阳性组中，19例接受检测的患者中有6例（31.6%）检测到T790M突变。肿瘤PD-L1表达阴性组和阳性组的EGFR-TKIs治疗中位（95%置信区间）时间分别为21.7（12.9 - 24.8）个月和12.3（5.6 - 22.2）个月。使用Cox比例风险模型分析确定，体能状态和肿瘤PD-L1表达的有无与EGFR-TKIs治疗时间显著相关。
肿瘤PD-L1表达阴性的EGFR突变NSCLC患者显示出更高的T790M突变获得率和奥希替尼治疗实施率，从而导致EGFR-TKI治疗时间更长。
