Clinical significance of 22C3-PD-L1 IHC expression in surgically resected non-small cell lung cancer
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AbstractBackground: Multiple studies correlated PD-L1 expression with clinicopathologic and survival have reported conflicting results.Methods: We retrospectively collected 185 patients with NSCLC who underwent surgical resection to detect PD-L1 IHC using the clone 22C3 pharmDx kit and evaluated PD-L1 expression along with clinicalpathological characteristics and prognosis.Results: Most of tumors had TNM stage lower than stage III. Adenocarcinoma and squamous carcinoma was accounting for 56.8% and 43.2%, respectively. Heterogeneous distribution of PD-L1 staining was observed, PD-L1 strong-positive and weak-positive staining were detected in 11.4% and 24.3% of patients. In univariate analysis, smokers, squamous carcinoma, central type cancer, larger primary tumor size, metastatic lymphonode, neoadjuvant chemotherapy and TILs present was found associations with higher proportion of PD-L1 positive expression. In multivariate analysis, only primary tumor size, smoking status, TILs status and neoadjuvant chemotherapy were confirmed associations with PD-L1 positive expression. Especially, PD-L1 positive expression rate climbed gradually with the increase of tumor size, T≤3cm 21.0%, 3cm < T≤5cm 32.8%, 5cm < T 50.7%, respectively, p = 0.003. PD-L1 positive expression highly improved with patients with neoadjuvant chemotherapy versus without neoadjuvant chemotherapy, 88.9% vs 33.0%, respectively, p = 0.009. In survival analysis, neither PD-L1 expession/TILs status nor the interaction term between were confirmed as independent prognosis biomarkers . PD-L1 negative group had a tendency of longer OS than PD-L1 positive group, mOS 66.4 months (95%CI, 59.4-73.4) vs. 39.2 months (95%CI, 16.0-62.4), respectively, p = 0.096. Conclusions: PD-L1 expression showed heterogeneous distribution and was highly influenced by tumor size, smoking status, TILs and neoadjuvant chemotherapy.It indicated a strong spatial and temporal variability in the PD-L1 expression, which could be in part to explain the conflicting results in PD-L1 expression and correlation with clinicopathologic in multiple studies. The dynamics of PD-L1 expression may also limit its use as a prognosis biomarker
All Author(s) ListGen Lin, Chao Li, Cheng Huang, Rong Xi Fang, Peng Hai Xu, Dong xian Lin, Biao Wu, Xiaohui Chen, Chunwei Xu, Tony Mok
Name of Conference2017 ASCO Annual Meeting
Start Date of Conference02/06/2017
End Date of Conference06/06/2017
Place of ConferenceChicago, Illinois
Country/Region of ConferenceUnited States of America
Proceedings TitleJournal of Clinical Oncology
Series TitleLBA Late-Breaking Abstract
Number in Seriesabstr; e20507
Volume Number35
LanguagesEnglish-United Kingdom

Last updated on 2018-18-01 at 11:19