Effect of Platinum-Based Chemotherapy on PD-L1 Expression on Tumor Cells in Non-small Cell Lung Cancer
- Author:
Junghoon SHIN
1
;
Jin Haeng CHUNG
;
Se Hyun KIM
;
Kyu Sang LEE
;
Koung Jin SUH
;
Ji Yun LEE
;
Ji Won KIM
;
Jeong Ok LEE
;
Jin Won KIM
;
Yu Jung KIM
;
Keun Wook LEE
;
Jee Hyun KIM
;
Soo Mee BANG
;
Jong Seok LEE
Author Information
- Publication Type:Original Article
- Keywords: Non-small cell lung carcinoma; PD-L1; Platinum; Neoadjuvant therapy; Prognosis
- MeSH: Carcinoma, Non-Small-Cell Lung; Drug Therapy; Humans; Immunohistochemistry; Neoadjuvant Therapy; Platinum; Prognosis; Retrospective Studies
- From:Cancer Research and Treatment 2019;51(3):1086-1097
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Programmed death-1 (PD-1)/PD-1 ligand (PD-L1) axis blockades have revolutionized the treatment of advanced non-small cell lung cancer (NSCLC). We assessed the effect of platinum-based chemotherapy on tumor PD-L1 expression and its clinical implications. MATERIALS AND METHODS: We used immunohistochemistry to retrospectively evaluate the percentage of tumor cells with membranous PD-L1 staining (tumor proportion score) in paired tumor specimens obtained before and after platinum-based neoadjuvant chemotherapy (NACT) in 86 patients with NSCLC. We analyzed the correlation between the change in PD-L1 tumor proportion score and clinicopathologic characteristics, response to NACT, and survival. RESULTS: The PD-L1 tumor proportion score increased in a significant proportion of patients with NSCLC after platinum-based NACT (Wilcoxon signed-rank test, p=0.002). That pattern was consistent across clinically defined subgroups except for patients with partial response to NACT. Tumors from 26 patients (30.2%) were PD-L1‒negative before NACT but PD-L1-positive after NACT, whereas the reverse pattern occurred in six patients (7%) (McNemar’s test, p < 0.001). Increase in PD-L1 tumor proportion score was significantly associated with lack of response to NACT (Fisher exact test, p=0.015). There was a tendency, albeit not statistically significant, for patients with an increase in PD-L1 tumor proportion score to have shorter survival. CONCLUSION: Tumor PD-L1 expression increased after platinum-based NACT in a significant proportion of patients with NSCLC. Increase in tumor PD-L1 expression may predict poor clinical outcome.
