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D. Cronin-Fenton
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-043 - PD-L1 Expression, EGFR and KRAS Mutations in First-Line Therapy (1L) for Non-Small Cell Lung Cancer (NSCLC) Patients (ID 10061)
09:00 - 16:00 | Author(s): D. Cronin-Fenton
- Abstract
Background:
The association of PD-L1 expression, KRAS and EGFR mutations, and survival in NSCLC patients who received 1L therapy was examined.
Method:
1L metastatic NSCLC patients diagnosed during 2001-2012 who had sufficient archival tumor tissue were selected from the Danish Lung Cancer Group Registry. Medical data from population-based medical registries and paraffin-embedded tumor tissue from pathology archives were retrieved. PD-L1 expression was assessed at two cut-offs (25% and >1%) using the Ventana IHC (SP263) assay, KRAS and EGFR genotyping was performed using PCR-based kits. Follow-up started at commencement of 1L therapy and continued to death, emigration, or 31/12/2014. Cox regression models were used to compute hazard ratios (HRs) and associated 95% confidence intervals (95%CI) for PD-L1, EGFR, and KRAS.
Result:
Among 491 patients, 280 (57%) were men and 334 (68%) were aged >60 years at diagnosis; 283 (58%) had adenocarcinoma, 152 (31%) had PD-L1 expression ≥25%, 23 (5%) had EGFR mutations, and 130 (26%) had KRAS mutations. In PD-L1 >25% tumors, 4% had EGFR and 30% had KRAS mutations. In PD-L1 <25% tumors, 16% had EGFR and 27% had KRAS mutations. Patients with a KRAS mutation had an increased risk of death and those with an EGFR mutation had a lower risk of death, but neither estimate was statistically significant (Table). Adjusted exploratory analyses indicated that tumor PD-L1 >25% was not associated with survival, however immune cell expression for PD-L1 at the 1% threshold and increasing tumor infiltration with immune cells were both significantly associated with a survival benefit.
*Adjusted for age, sex, and histology (adenocarcinoma versus other). [§] Excluding those with missing PD-L1, KRAS or EGFR status, respectivelyNo of deaths during follow-up / N (%) Median Survival (months) (95%CI) Adjusted HR* (95%CI) % Tumor expression[§] PD-L1 < 25% 208/307 (67.8) 23.6 (18.1, 27.5) ref. PD-L1 > 25% 101/152 (66.4) 23.3 (16.9, 29.4) 0.96 (0.76, 1.22) EGFR[§] Wildtype 284/419 (67.8) 23.3 (18.4, 26.0) ref. Mutant 13/23 (56.5) 32.8 (18.2, 92.5) 0.75 (0.43, 1.32) KRAS[§] Wildtype 193/309 (62.5) 24.7 (20.0, 29.1) ref. Mutant 95/130 (73.1) 19.4 (15.3, 26.4) 1.28 (0.99, 1.65) % Immune cell expression[§] PD-L1 < 25% 264/387 (68.2) 21.8 (18.1, 25.1) ref. PD-L1 > 25% 45/72 (62.5) 30.2 (17.3, 44.2) 0.86 (0.61, 1.20) % Immune cells (1% threshold)[ §] PD-L1 < 1% 92/122 (75.4) 16.5 (13.3, 20.2) ref. PD-L1 > 1% 217/337 (64.4) 26.7 (23.2, 30.2) 0.62 (0.48, 0.80) % Tumor with Immune Cells (‘infiltration’; continuous) 309/459 (67.3) 23.6 (18.5, 26.4) 0.98 (0.97, 0.99)
Conclusion:
Immune cell expression of PD-L1 and tumor infiltration by immune cells are associated with survival among 1L lung cancer patients. These findings are based on a small cohort and further study is warranted.
