Abstract | INTRODUCTION: METHODS AND MATERIALS: Using immunohistochemical (IHC) staining, we retrospectively tested PD-L1 expression (Dako 22C3) in the pre-treatment tumours from advanced EGFR mutant lung ADC patients, of whom all were treated with TKIs. Multiplex IHC assay was applied for exploring immune cells in tumour microenvironments. RESULTS: A total of 153 Taiwanese patients were enrolled in our study, of whom a majority of cases were female (58.9%) and non-smokers (75.8%). The objective response rate (ORR) to EGFR TKI and progression-free survival (PFS) were better in patients with PD-L1 expression <50% (ORR/PFS in PD-L1 0% versus 1-49% versus ≥50%: 65.6%/12.5 months versus 56.4%/12.8 months versus 38.9%/5.9 months, P < 0.05). The multivariate analysis showed that PD-L1 <50% was an independent prognostic factor for longer PFS (hazard ratio (HR) 0.433, 95% confidence interval (CI) 0.250-0.751, P = 0.003). Furthermore, tumours with higher PD-L1 expression were less likely to develop a secondary T790M mutation (T790M+ in PD-L1 0% versus 1-49% versus ≥50%: 53.7% versus 35.7% versus 10%, P = 0.024). Multiplex IHC tests were applied in 15 cases and revealed a potential correlation between PD-L1, immune cells, and EGFR TKI responses. CONCLUSIONS: Lower pre-treatment PD-L1 is associated with better ORR, PFS, and higher frequency of T790M resistance in EGFR TKI-treated lung ADC patients.
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Authors | Ching-Yao Yang, Wei-Yu Liao, Chao-Chi Ho, Kuan-Yu Chen, Tzu-Hsiu Tsai, Chia-Lin Hsu, Kang-Yi Su, Yih-Leong Chang, Chen-Tu Wu, Chia-Chi Hsu, Bin-Chi Liao, Wei-Hsun Hsu, Jih-Hsiang Lee, Chia-Chi Lin, Jin-Yuan Shih, James C-H Yang, Chong-Jen Yu |
Journal | European journal of cancer (Oxford, England : 1990)
(Eur J Cancer)
Vol. 124
Pg. 110-122
(01 2020)
ISSN: 1879-0852 [Electronic] England |
PMID | 31760310
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 Elsevier Ltd. All rights reserved. |
Chemical References |
- B7-H1 Antigen
- CD274 protein, human
- Protein Kinase Inhibitors
- EGFR protein, human
- ErbB Receptors
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Topics |
- Adenocarcinoma of Lung
(drug therapy, genetics, immunology, pathology)
- Adult
- Aged
- Aged, 80 and over
- B7-H1 Antigen
(biosynthesis, immunology)
- ErbB Receptors
(antagonists & inhibitors, genetics, immunology)
- Female
- Humans
- Lung Neoplasms
(drug therapy, genetics, immunology, pathology)
- Male
- Middle Aged
- Mutation
- Progression-Free Survival
- Protein Kinase Inhibitors
(therapeutic use)
- Retrospective Studies
- Tumor Microenvironment
(immunology)
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