Author of

• 25904

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  MA15 - Colliding Approaches - EGFR and Immunotherapy (ID 916)

  • Event: WCLC 2018
  • Type: Mini Oral Abstract Session
  • Track: Targeted Therapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 13:30 - 15:00, Room 107

  • 26032

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    MA15.01 - Strong PD-L1 Expression Predicts Poor Response and de Novo Resistance to EGFR TKIs Among Non-Small Cell Lung Cancer Patients with EGFR Mutation (ID 12920)

    13:30 - 13:35  |  Author(s): Jin-Ji Yang
    • Abstract
    • Presentation
    • Slides

    Background
    

    This study evaluated whether tumor expression of programmed death-ligand 1 (PD-L1) predicted the response of EGFR-mutated non-small cell lung cancer (NSCLC) to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We retrospectively evaluated patients who received EGFR-TKIs for advanced NSCLC between April 2016 and September 2017 at the Guangdong Lung Cancer Institute. None of them were enrolled in clinical studies, and their EGFR and PD-L1 statuses were simultaneously evaluated.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Among the 101 eligible patients, strong PD-L1 expression significantly decreased the objective response rate (ORR) compared with those with weak or negative PD-L1 expression (35.7% vs 63.2% vs 67.3%, P=0.002) as well as shortened progression-free survival (PFS, 3.8months vs 6.0months vs 9.5months, P<0.001), regardless of EGFR mutation types (19del or L858R). Furthermore, positive PD-L1 expression was predominantly observed among patients with de novo resistance rather than acquired resistance to EGFR-TKIs (66.7% vs 30.2%, P=0.009). Notably, patients with de novo resistance had a high proportion of dual positive for PD-L1 and CD8 (46.7%, 7/15). Finally, one patient with de novo resistance to EGFR-TKIs and dual positivity for PD-L1 and CD8 experienced a favorable response to anti-PD-1 therapy.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    This study uncovered the adverse impact of PD-L1 expression on the efficacy of EGFR- TKIs, especially in those with de novo resistance NSCLC, which inclined to reshape an inflamed immune phenotype of dual positive for PD-L1 and CD8 and showed potential therapeutic sensitivity to PD-1 blockade.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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• 25941

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  P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27007

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    P2.04-30 - PD-1/PD-L1 Inhibition Might be an Option for the Treatment of Advanced Primary Pulmonary Lymphoepithelioma-Like Carcinoma (ID 12698)

    16:45 - 18:00  |  Author(s): Jin-Ji Yang
    • Abstract
    • Slides

    Background
    

    Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small-cell lung cancer mostly reported in Asian countries, which is frequently associated with Epstein-Barr virus (EBV) infection. There is no consensus on the choice for the treatment of advanced primary pulmonary LELC. The utility of PD-1/PD-L1 inhibitor to this cancer type remains poorly understood.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    From January 2008 to April 2017, a total of 53 patients receiving surgical removal and diagnosed as primary pulmonary LELC in Guangdong Lung Cancer Institute (GLCI) were enrolled in this study. Sections formalin-fixed and paraffin-embedded (FFPE) tumor samples were stained with PD-L1 antibody (clone E1L3N, Cell Signaling Technology) by immunohistochemistry (IHC). PD-L1 expression more than 1% in tumor cells was considered as PD-L1 positive. Moreover, we reviewed the medical records of 13 primary pulmonary LELC patients who received the treatment of PD-1/PD-L1 inhibitors in GLCI. Their clinicopathological characteristics and relevant prognostic data were analyzed.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Among the 53 patients with operable disease, the median age was 56 (36-78), there were 26 males and 27 females, 15 smokers and 38 nonsmokers. Positive rates of PD-L1 in the early pulmonary LELC were 78.8% (41/52,one specimen can't evaluate) and 73.1% (38/52) and 23.1% (12/52) respectively at the cutoff values of 1% and 5% and 50% positivity in tumor cells. ORR of PD-1/PD-L1 inhibition in the evaluable 12 patients with advanced LELC was 16.7% (2/12), and DCR was 75.0% (9/12). In the 6 patients with positive PD-L1 expression, ORR was 33.3% (2/6), DCR was 100.0% (6/6). The two responder patients got 55% and 64% shrinkage of the tumors respectively. All patients had no EGFR mutations.

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    This preliminary study showed that pulmonary LELCs have remarkably high incidence of PD-L1 expression. PD-1/PD-L1 inhibitors might be an option for the treatment of advanced primary pulmonary LELC, which needs further investigation.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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