Programmed cell death ligand-1 expression and survival in a cohort of patients with non-small cell lung cancer receiving first-line through third-line therapy in Denmark |
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Affiliation: | 1. EpidStrategies, Rockville, MD, USA;2. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark;3. AstraZeneca, Gaithersburg, MD, USA;4. Institute of Pathology, Aarhus University Hospital, Aarhus, Denmark;5. AstraZeneca, Cambridge, United Kingdom;6. Bornholms Hospital, Copenhagen, Denmark;7. Danish Lung Cancer Group, Odense, Denmark;8. Department of Respiratory Medicine, Aarhus University Hospital, Aarhus, Denmark;1. Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Division of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan;3. Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;4. Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan;1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China;2. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China;3. Xuzhou Institution of Health Inspection, Xuzhou, Jiangsu, 221000, PR China;1. National Cancer Control Programme, No. 555/5, Public Health Building Complex, Elvitigala Mawatha, Colombo 5, Sri Lanka;2. Sri Lanka Cancer Research Group, Maharagama, Sri Lanka;3. Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Australia;4. WHO Country Office for Sri Lanka, No. 5, Anderson Road, Colombo 5, Sri Lanka;1. Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic;2. Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic;3. Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic;4. Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic;5. Department of Medical Ethics, Faculty of Medicine, Masaryk University, Brno, Czech Republic;6. Department of Internal Medicine, Haematology and Oncology, University Hospital Brno and Masaryk University, Brno, Czech Republic;1. Department of Gynecological Oncology, Tianjin Central Hospital of Obstetrics & Gynecology, Tianjin, 300100, China;2. Department of Pathology, Tianjin Central Hospital of Obstetrics & Gynecology, Tianjin, 300100, China;1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK;2. Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK;3. Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK;4. Department of Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK |
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Abstract: | BackgroundPD-L1 expression on tumor cells (TCs) or immune cells (ICs) may be used as a prognostic marker for survival in patients with NSCLC. We characterized PD-L1 expression on TCs or ICs in a patient cohort with NSCLC to determine associations between PD-L1 expression and overall survival (OS), according to EGFR and KRAS mutation status.MethodsDanish patients aged >18 years diagnosed with NSCLC before 2014 on first- (N = 491), second- (N = 368), or third-line (N = 498) therapy were included. Data were extracted from population-based medical registries. Tumor samples from pathology archives were tested for biomarkers. High PD-L1 expression was defined as expression on ≥25 % of TCs or ICs based on first diagnostic biopsy or surgical resection. KRAS and EGFR mutation status were tested using PCR-based assays. Cox regression analysis was used to compute adjusted HRs and associated 95 % CIs.ResultsPD-L1 TC and IC ≥ 25 % were observed in 24.3 %–31.0 % and 11.7–14.7 % of patients, respectively. EGFR and KRAS mutations were detected in 4.7 %–8.8 % and 26.5 %–30.7 % of patients, respectively. PD-L1 TC ≥ 25 % was not associated with survival advantage in first- (HR = 0.96, 95 % CI: 0.75–1.22), second- (1.08, 0.81–1.42), or third-line (0.94, 0.74–1.20) therapy. PD-L1 IC ≥ 25 % was associated with survival advantage in second-line (HR = 0.56, 95 % CI: 0.36–0.86) and third-line (0.69, 0.49–0.97) but not first-line (1.00, 0.70–1.41) therapy.ConclusionNo association was observed between PD-L1 TC ≥ 25 % and OS in any therapy line. PD-L1 IC ≥ 25 % may confer survival benefit among some patients who reach second-line therapy. |
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Keywords: | PD-L1 expression Non-small cell lung cancer |
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