A Real-world Study on the Assessment of Pathological Characteristics and Targeted Therapeutic Effect of Non-small Cell Lung Cancer Patients with Positive Driving Genes and High PD-L1 Expression.
10.3779/j.issn.1009-3419.2021.104.02
- Author:
Hui ZHANG
1
;
Xinjie YANG
1
;
Kun LI
2
;
Jinghui WANG
1
;
Jialin LV
1
;
Xi LI
1
;
Xinyong ZHANG
1
;
Na QIN
1
;
Quan ZHANG
1
;
Yuhua WU
1
;
Li MA
1
;
Fei GAI
3
;
Ying HU
1
;
Shucai ZHANG
1
Author Information
1. Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor
Research Institute, Beijing 101149, China.
2. Department of Pathology, Beijing Chest Hospital, Capital Medical University/Beijing
Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
3. Amoy Diagnostics Co.,Ltd, Xiamen 361000, China.
- Publication Type:Journal Article
- Keywords:
Driver mutation;
Lung neoplasms;
Programmed death-ligand 1;
Targeted treatment
- From:
Chinese Journal of Lung Cancer
2021;24(2):78-87
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Targeted therapy for patients with driver genes positive and immunotherapy for patients with driver gene-negative but high programmed death ligand 1 (PD-L1) expression are the standards of first-line treatment for patients with advanced non-small cell lung cancer (NSCLC). The treatment options for patients with driver gene positive and high PD-L1 expression are still worth exploring.
METHODS:The characteristics of 315 patients with NSCLC were identified to analyze the clinicopathological characteristics of patients with driver gene positive and high PD-L1 expression, and the efficacy of targeted therapy.
RESULTS:Among the 315 patients, the total positive rate of driver genes was 62.2%, and the high PD-L1 expression rate (≥50.0%) was 11.2%. The proportion of patients with driver gene positive and high PD-L1 expression was 10.7%. PD-L1 was highly expressed in patients with epidermal growth factor receptor (EGFR) mutation, KRAS mutation, ALK fusion, BRAF mutation, and MET 14 exon skip mutation, the proportions were 7.8% (11/141), 18.2% (4/22), and 23.1%, (3/13), 50.0% (2/4) and 100.0% (1/1) respectively. EGFR mutation positive with PD-L1 high expression was mainly in patients with stage IV lung adenocarcinoma. KRAS mutation positive with PD-L1 high expression was mainly in patients with a history of smoking. Among them, two patients were followed in detail for targeted therapy, who with ALK fusion-positive and PD-L1 high expression (90.0%), EGFR L858R mutation and PD-L1 high expression (70.0%) respectively. The total OS of the patients was 5 months, 2 months.
CONCLUSIONS:The high PD-L1 expression rate in NSCLC patients with different driver gene mutations was variable, which maybe correlated with distinct clinicopathological characteristics. Patients with sensitive mutations and high PD-L1 expression may be less benefit from targeted therapy and have poor prognosis.
