Prognostic Impact of Programmed Death-ligand 1 and Surrounding Immune Status on Stage I Lung Cancer.

Abstract

BACKGROUND:

The programmed death 1/programmed death-ligand 1 (PD-L1) pathway reportedly is as an important factor determining effects of immunotherapy; however, its prognostic impact is controversial, and its association with the surrounding immune microenvironment has not yet been elucidated.

PATIENTS AND METHODS:

We retrospectively analyzed 126 patients with pathologic stage I non-small-cell lung cancer. Patients with lepidic-dominant adenocarcinoma were excluded. PD-L1 expression was evaluated with immunohistochemistry correlated with clinicopathologic features and surrounding immune microenvironment status, including CD4, CD8, regulatory T cells, and human leukocyte antigen class I. Factors affecting prognosis were assessed by Kaplan-Meier and Cox regression analyses.

RESULTS:

Twenty-three (18.3%) patients were positive for PD-L1 expression. No significant correlation was observed between PD-L1 expression and the surrounding immune microenvironment status. The PD-L1-positive group had a worse prognosis than the PD-L1-negative group (5-year recurrence-free survival rates, 63.4% vs. 81.0%; P = .061). Among surrounding immune cells, intratumoral CD8 status had the strongest impact on prognosis (P = .12). In the intratumoral CD8-high group, PD-L1 expression demonstrated no significant prognostic impact, whereas in the intratumoral CD8-low group, patients positive for PD-L1 demonstrated a significantly worse prognosis than those negative for PD-L1 (5-year recurrence-free survival rates, 41.7% vs. 78.6%; P = .034). Multivariable Cox regression analysis revealed that 'PD-L1-positive and intratumoral CD8-low' status was an independent prognostic factor (hazard ratio, 3.80; 95% confidence interval, 1.22-10.5; P = .023).

CONCLUSIONS:

The prognostic impact of the PD-1/PD-L1 pathway may be distinct according to concurrent intratumoral CD8 status.

• Authors: Yoshinori Handa, Yasuhiro Tsutani, Noriyuki Shiroma, Yuichiro Kai, Takahiro Mimae, Yoshihiro Miyata, Yukio Takeshima, Koji Arihiro, Morihito Okada
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 21 Issue 4 Pg. e302-e314 (07 2020) ISSN: 1938-0690 [Electronic] United States
• PMID: 32102750 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• B7-H1 Antigen
• CD274 protein, human
• PDCD1 protein, human
• Programmed Cell Death 1 Receptor

Topics

• Adenocarcinoma of Lung (immunology, metabolism, pathology, surgery)
• Aged
• B7-H1 Antigen (immunology, metabolism)
• CD8-Positive T-Lymphocytes (immunology)
• Carcinoma, Non-Small-Cell Lung (immunology, metabolism, pathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (immunology, metabolism, pathology, surgery)
• Lymphocytes, Tumor-Infiltrating (immunology)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (immunology, metabolism, pathology, surgery)
• Neoplasm Staging
• Programmed Cell Death 1 Receptor (immunology, metabolism)
• Retrospective Studies
• Survival Rate
• Tumor Microenvironment (immunology)