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M. Hojo



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    P1.01 - Advanced NSCLC (ID 757)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.01-054 - PD-L1 Expression in Patients with Non-Small Cell Lung Cancer According to Underlying Pulmonary Disease: A Retrospective Study (ID 8705)

      09:30 - 16:00  |  Author(s): M. Hojo

      • Abstract
      • Slides

      Background:
      Immune checkpoint inhibitors (ICIs) have good treatment outcomes for non-small cell lung cancer (NSCLC) especially with smoking history. The drug-induced interstitial lung diseases (ILDs) are frequently seen in patients treated with ICIs. The risk assessment for ILDs before ICIs treatment is important, however the pulmonary toxicities of ICIs in patients with smoking related pulmonary diseases such as emphysema and fibrosis are not known. In this study, we retrospectively analyzed PD-L1 expression of NSCLC according to underlying pulmonary disease.

      Method:
      We tested PD-L1 expressions in NSCLC using 22C3 antibody as tumor proportion score (TPS). We then compared PD-L1 expression TPS according to underlying pulmonary diseases assessed by chest CT (normal, fibrosis, emphysema).

      Result:
      We reviewed 44 NSCLC patients at NTT Medical Center Tokyo. The median age of all the patients was 71 years (range 46-90). Thirty-eight patients were male (86%). Adenocarcinoma was the most frequent with 26 patients (59%), followed by squamous cell carcinoma with 16 patients (36%). As to PD-L1 expression, 7 patients (16%) were TPS more than 50%, 12 patients (27%) were TPS 1-49% and 22 patients (50%) were TPS less than 1%. Three patients (7%) did not have evaluable material. All the patients with TPS >50% and 1-49% had smoking history. For patients with TPS <1%, there were three patients (14%) without smoking history. As to histology, there were 4 patients (57%) with squamous cell carcinoma for patients with TPS >50%, 4 patients (33%) for TPS 1-49% and 8 patients (36%) for TPS <1%. Among patients with TPS >50%, 2 patients (29%) had emphysema, 5 patients (23%) fibrosis, and no normal lung. Among patients with TPS 1-49%, there were 4 patients (33%) with normal lung, 6 patients (50%) with emphysema and 2 patients (17%) with fibrosis. For patients with TPS <1, there were 9 patients (41%) with normal lung, 10 patients (45%) with emphysema and 2 patients (9%) with fibrosis.

      Conclusion:
      No patients with normal lungs showed TPS >50%, whereas more than half of patients with TPS <1% had normal lung. Our results show that patients with higher PD-L1 expression has higher rate of underlying pulmonary disease which might be a higher risk for drug-related ILDs. Further treatment strategy is needed for use of ICIs with higher PD-L1 expression with underlying pulmonary diseases.

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