Abstract
Background
PD-1/PD-L1 inhibitors is the important drugs of immunotherapy for malignant tumors. PD-L1 expression is an important biomarker of selecting patients for ICIs therapy. However, the correlation of PD-L1 expression with clinicopathologic features in lung adenocarcinoma remains controversial.
Methods
PD-L1 expression was tested using clone SP263 by immunohistochemistry (IHC) on Ventana automated Benchmark in tissue micro-arrays (TMA) in lung adenocarcinoma. The association of PD-L1 expression with clinicopathologic characteristics, including gender, age, histological subtype, smoking history, stage, and genotype were analyzed.
Results
404 patients were available for analyzing. The incidence of PD-L1 expression was 22.5% (using a cutoff of ≥ 25%). Statistical analysis showed PD-L1 expression was associated with advanced stage, lymph node (LN) metastasis, solid predominant subtype and wild-type epidermal growth factor receptor (EGFR) gene. In subgroup analysis, PD-L1 expression in patients with EGFR exon 19 deletions was higher than that of with EGFR L858R mutation at exon 21 (21.6% vs. 10.2%, P = 0.046). In multivariate analysis for overall survival (OS) by Cox hazard proportion model, patients with EGFR gene mutations (HR 1.635, 95% CI 1.310–2.040, P < 0.001) and early stage (HR 2.495, 95% CI 2.003–3.106, P < 0.001) had a longer survival, while PD-L1 expression was not associated with overall survival (HR 0.847, 95% CI 0.655–1.094, P = 0.203).
Conclusion
For patients with lung adenocarcinoma, LN metastasis, wild-type EGFR, advanced stage, solid predominant subtype were independent predictors of PD-L1 expression by multivariate analysis. PD-L1 expression may be not a predictor of OS for patients with lung adenocarcinoma.
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Funding
This work were supported by the foundation from the National Key Research and Development Program of China (2017YFC1309004), Pathology Research Centre of the China Academy of Medical Sciences (Project No. 2016ZX310176-2) and CAMS Initiative for Innovative Medicine (2017-12M-1-005).
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All the patients signed the written informed consents prior to enrollment in this study. This study was conducted according to the principles of the Declaration of Helsinki and approved by the ethical committees of Beijing Chest Hospital and Peking Union Medical College Hospital.
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Song, P., Wu, S., Zhang, L. et al. Correlation Between PD-L1 Expression and Clinicopathologic Features in 404 Patients with Lung Adenocarcinoma. Interdiscip Sci Comput Life Sci 11, 258–265 (2019). https://doi.org/10.1007/s12539-019-00329-8
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DOI: https://doi.org/10.1007/s12539-019-00329-8