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Oncotarget. 2015 Jun 10;6(16):14209-19.

The association between PD-L1 and EGFR status and the prognostic value of PD-L1 in advanced non-small cell lung cancer patients treated with EGFR-TKIs.

Tang Y1,2,3, Fang W1,2,3, Zhang Y1,2,3, Hong S1,2,3, Kang S1,2,3, Yan Y1,2,3, Chen N1,2,3, Zhan J1,2,3, He X1,2,3, Qin T1,2,3, Li G4, Tang W5, Peng P5, Zhang L1,2,3.

Author information

1
Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
2
State Key Laboratory of Oncology in South China, Guangzhou, China.
3
Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
4
Key Laboratory for Stem Cells and Tissue Engineering, Sun Yat-sen University, Guangzhou, China.
5
Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhu Hai, China.

Abstract

BACKGROUNDS:

Recent clinical trials have shown that immune-checkpoint blockade yields remarkable response in a subset of non-small cell lung cancer (NSCLC) patients. However, few studies directly focus on the association between epidermal growth factor receptor (EGFR) mutational status and programmed cell death-ligand 1 (PD-L1) expression. We examined whether PD-L1 is related to clinicopathologic factors and prognosis in patients with advanced NSCLC treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs).

METHODS:

One-hundred and seventy patients with advanced NSCLC were explored. Paraffin-embedded tumour sections were stained with PD-L1 antibody. EGFR mutation was examined by fluorescent quantitative polymerase chain reaction (PCR). The correlations between PD-L1 expression and EGFR status and survival parameters were analyzed.

RESULTS:

The overall frequency of PD-L1 over-expression was 65.9% (112/170). In lung adenocarcinoma, PD-L1 tended to be associated with mutant EGFR (PD-L1 overexpression in mutant and wild-type EGFR, 64/89 (71.9%) vs. 32/56 (57.1%), respectively; p=0.067). Subgroup analyses showed that high PD-L1 expression was associated with significantly shorter overall survival (OS) in EGFR wild-type patients (p=0.029) but not in EGFR mutant patients (p=0.932) treated with EGFR-TKIs. Even more, for EGFR mutant patients, higher expression of PD-L1 might only signal better outcome with TKIs.

CONCLUSIONS:

High PD-L1 expression was likely to be associated with the presence of EGFR mutation in advanced lung adenocarcinoma. For EGFR wild-type patients, the PD-L1 over expression can be considered as a poor prognostic indicator of OS.

KEYWORDS:

EGFR status; NSCLC; PD-L1; TKI; prognosis

PMID:
25895031
PMCID:
PMC4546461
DOI:
10.18632/oncotarget.3694
[Indexed for MEDLINE]
Free PMC Article

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