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Ann Oncol. 2014 Oct;25(10):1935-40. doi: 10.1093/annonc/mdu242. Epub 2014 Jul 9.

Association of PD-L1 overexpression with activating EGFR mutations in surgically resected nonsmall-cell lung cancer.

Author information

1
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume.
2
Research Institute for Disease of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
3
Department of Diagnostic Pathology, Kurume University Hospital, Kurume.
4
Biostatistics Center, Kurume University, Kurume.
5
Department of Surgery, Kurume University School of Medicine, Kurume.
6
Research Institute for Disease of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan.
7
Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan okamotoi@kokyu.med.kyushu-u.ac.jp.

Abstract

BACKGROUND:

Recent clinical trials have shown that immune-checkpoint blockade yields a clinical response in a subset of individuals with advanced nonsmall-cell lung cancer (NSCLC). We examined whether the expression of programmed death-ligand 1 (PD-L1) is related to clinicopathologic or prognostic factors in patients with surgically resected NSCLC.

PATIENTS AND METHODS:

The expression of PD-L1 was evaluated by immunohistochemical analysis in 164 specimens of surgically resected NSCLC. Cell surface expression of PD-L1 in NSCLC cell lines was quantified by flow cytometry.

RESULTS:

Expression of PD-L1 in tumor specimens was significantly higher for women than for men, for never smokers than for smokers, and for patients with adenocarcinoma than for those with squamous cell carcinoma. Multivariate analysis revealed that the presence of epidermal growth factor receptor gene (EGFR) mutations and adenocarcinoma histology were significantly associated with increased PD-L1 expression in a manner independent of other factors. Cell surface expression of PD-L1 was also significantly higher in NSCLC cell lines positive for activating EGFR mutations than in those with wild-type EGFR. The EGFR inhibitor erlotinib downregulated PD-L1 expression in the former cell lines but not in the latter, suggesting that PD-L1 expression is increased by EGFR signaling conferred by activating EGFR mutations. A high level of PD-L1 expression in resected tumor tissue was associated with a significantly shorter overall survival for NSCLC patients.

CONCLUSIONS:

High expression of PD-L1 was associated with the presence of EGFR mutations in surgically resected NSCLC and was an independent negative prognostic factor for this disease.

KEYWORDS:

EGFR-TKI; PD-L1; activating EGFR mutation; immunohistochemistry; nonsmall-cell lung cancer

PMID:
25009014
DOI:
10.1093/annonc/mdu242
[Indexed for MEDLINE]

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