PD-L1 expression can be regarded as prognostic factor for survival of non-small cell lung cancer patients after chemoradiotherapy

Abstract

Inoperable locally advanced non-small cell lung cancer (LA NSCLC) is treated with concurrent or sequential chemotherapy (ChT) and radiation therapy (RT). Survival rates with this treatment remains poor, reported 5-year survival is about 15%. New treatment strategies, including immunotherapy with programmed death ligand-1 (PD-L1) check point inhibitors are being investigated. The clinical significance of PD-L1 expression in tumor samples from patients with inoperable LA NSCLC who underwent concurrent chemoradiotherapy (CRT) in our institution between 2005 and 2010 was evaluated. The expression of PD-L1 was correlated with clinical and pathological parameters and outcome of treatment. We analysed 107 patients treated with concurrent CRT. Only 43 patients (36 males and 7 females) had sufficient tissue for immunohistochemical (IHC) staining. PD-L1 expression was demonstrated in 7 tumors. No statistical significant differences in patient characteristics, including age, smoking status and gender, were found according to the PD-L1 expression. After a median follow up of 103.6 months, median progression free survival (PFS) was 19.9 months in patients without and 10.1 months in patients with PD-L1 expression (p=0.006). Median overall survival (OS) was 28.4 and 12.1 months for PD-L1 negative and PD-L1 positive patients, respectively (p=0.012).In conclusions, PD-L1 expression was negative prognostic factor for PFS and OS after concurrent CRT in LA NSCLC. As only small number of patients had enough tissue for the IHC testing, no firm conclusions could be made and further investigation is warranted.

Prognostic value of PD-L1 expression in patients with unresectable stage III non-small cell lung cancer treated with chemoradiotherapy

“…The objective of present analysis was the confirmation of our previously published data about prognostic value of PD-L1 expression on survival of patients with unresectable NSCLC in stage III that were treated with definitive combined RT and ChT [ 11 ]. In present retrospective analysis, we found no difference between PFS and OS of patients with NSCLC neither in group of ≥ 1% nor in ≥ 50% PD-L1 expression.…”

“…Expression of PD-L1 on tumor cells is one of the most investigated predictors of benefit from immune checkpoint blockade in advanced NSCLC but little is known about the association of PD-L1 expression and clinicopathological parameters including prognosis of patients with unresectable stage III NSCLC [ 6 – 10 ]. In our previous research, we assessed the impact of PD-L1 expression on tumor cells from patients with unresectable stage III NSCLC who were treated in our institution between 2005 and 2010 in prospective trial with concurrent chemotherapy (ChT) and radiotherapy (RT) [ 11 ]. We found significant shorter progression free survival (PFS) and overall survival (OS) in patients with PD-L1 expression.…”

Long-term survival of locally advanced stage III non-small cell lung cancer patients treated with chemoradiotherapy and perspectives for the treatment with immunotherapy

“…Ventana monoclonal antibody and an automated staining platform was used as described in our previous report. 14 …”

Immune RECIST criteria and symptomatic pseudoprogression in non-small cell lung cancer patients treated with immunotherapy

“…Expression of PD-L1 is the most studied predictor biomarker for anti-PD-L1 therapy. 35 , 36 , 37 Trials with pembrolizumab demonstrated improved outcomes in metastatic NSCLC patients with PD-L1 expression ≥ 50%. 23 , 25 Three patients in our review with symptomatic pseudoprogression that were treated with pembrolizumab had PD-L1 expression over 50%.…”