PD-L1 is a Prognostic Biomarker in Resected NSCLC Patients with Moderate/high Smoking History and Elevated Serum SCCA Level

Abstract

Programmed cell death-1 (PD-1) -targeted immunotherapy has become a promising treatment paradigm for patients with advanced non-small cell lung cancer (NSCLC). Clinical responses to checkpoint inhibition therapy in NSCLC have been associated with programmed death-1 ligand 1 (PD-L1) expression. However, the association between the expression of PD-L1 and PD-L2 and the clinicopathological features and patient outcomes in NSCLC remain unclear. We retrospectively analyzed 364 patients (158 squamous cell carcinoma and 206 adenocarcinoma) who underwent complete resection between 2009 and 2012. Expression of PD-L1 and PD-L2 was determined by immunohistochemistry. Correlations between PD-L1/PD-L2 expression and the clinicopathological features and survival parameters were analyzed and prognostic factors were identified. PD-L1 expression was significantly associated with moderate/heavy smoking history and serum squamous cell carcinoma antigen (SCCA) levels. Multivariate analysis showed patients with high PD-L1 expression had significantly shorter disease free survival (DFS, HR 1.411, P = 0.025) and overall survival (OS, HR 1.659, P = 0.004) than those with low PD-L1 expression at a 50% cutoff value. No significant association was found between PD-L2 expression and patient postoperative survival. Further stratification analysis revealed that in patients with moderate/heavy smoking history, elevated serum SCCA level, and squamous cell carcinoma, PD-L1 expression was associated with significantly shorter DFS and OS. Therefore, PD-L1 expression was correlated with moderate/heavy smoking history and elevated serum SCCA level in NSCLC patients, and was an independently poor predictor of survival.

Squamous cell carcinoma antigen concentration in fine needle aspiration samples: A new method to detect cervical lymph node metastases of head and neck squamous cell carcinoma

“…SCC‐Ag showed to be valuable as a prognostic serum tumor marker in cervical cancer and non‐small‐cell lung carcinoma, but not so in HNSCC . Because the diagnostic value of SCC‐Ag in FNA is a new finding, it would be of interest to see whether the SCC‐Ag concentration has any prognostic value.…”

“…The measurement of squamous cell carcinoma antigen (SCC‐Ag), originally purified from SCC of the human uterine cervix, could improve the detection of regional HNSCC lymph node metastases in addition to FNAC. Although SCC‐Ag is used as a prognostic serum tumor marker in cervical cancer and non‐small‐cell lung cancer, in HNSCC, the serum SCC‐Ag level showed no significant relation to lymph node metastasis and overall survival . To our knowledge, SCC‐Ag in FNA samples has not previously been studied.…”

Combination of PD-L1 expression and NLR as prognostic marker in patients with surgically resected non-small cell lung cancer

“…DFS and OS were stratified by median of NLR (2.3), which was also consisting with previous studies [15][16][17][18] . Epidermal growth factor receptor (EGFR) mutation status was detected by real-time PCR or DNA sequencing as previously described [19].…”

Clinical significance of ≥ 50% PD‐L1 expression with the SP263 monoclonal antibody in non‐small cell lung cancer patients

“…Although the association between PD-L1 expression and clinicopathological characteristics in NSCLC has already been examined, the relationship between oncogenic driver mutations, smoking history, and PD-L1 expression status remains unclear. Recent studies have demonstrated that high PD-L1expression is more frequently found in resected NSCLC patients with a smoking history, [9][10][11] while other studies have found no relationship. 12 Furthermore, detailed analysis of the association between PD-L1 expression and smoking variables was not performed in these studies.…”