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Kazuki Hayasaka

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    P1.09 - Pathology (Not CME Accredited Session) (ID 941)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.09-07 - PD-L1 Protein Expression is a Predictor of Benefit from Adjuvant Chemotherapy in Resected Non-Small Cell Lung Carcinoma (ID 11326)

      16:45 - 18:00  |  Author(s): Kazuki Hayasaka

      • Abstract
      • Slides


      Programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) are important targets of immunotherapy and its expression has been closely correlated with response and survival benefit from anti-PD-1/PD-L1 immune checkpoint inhibitor therapies in advanced non-small cell lung carcinoma (NSCLC). But it is still unclear whether PD-L1 is a prognostic or a predictive marker of adjuvant chemotherapy. The aim of this study is to examine the prognostic value of PD-L1 protein expression and its predictive role for adjuvant chemotherapy in surgically resected NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 407 NSCLC were examined. The male:female ratio was 288:119; the age range was between 38 and 85 years of age and the mean age was 68.5 years. Pathological stage’s ratio (I:II:III) was 147:154:106. Adenocarcinoma:Squamous cell carcinoma:Others’ ratio was 251:135:21 in histology. Adjuvant chemotherapy was performed in 173 patients. The follow up duration was from 0.4 months to 168.7 months and the mean duration was 61.9 months. Tissue microarray was constructed and PD-L1 protein expression was analyzed using immunohistochemistry (clone SP263, Ventana Medical Systems. Inc., Tucson, AZ). The PD-L1 staining percentage in tumor cells were classified as follows: Negative, 0%; Weak positive, 1-49%; Strong positive, 50-100%. The score of PD-L1 staining was correlated with clinicopathological backgrounds, molecular features, patient outcome and potential benefit of adjuvant chemotherapy.

      4c3880bb027f159e801041b1021e88e8 Result

      The score of PD-L1 staining was as follows: Negative, 265 (65%); Weak positive, 82 (20%); Strong positive, 60 (15%). PD-L1 expression status was associated with sex, smoking history, pathological stage, histology, p53 protein expression, MIB-1 labeling index. 5-year overall survival (OS) was as follows: Negative, 63.5%; Weak positive, 62.1%; Strong positive, 54.8% and 5-year recurrence-free survival (RFS) was as follows: Negative, 51.6%; Weak positive, 55%; Strong positive, 42.5%, respectively. These results were not statistically significant. Untreated patients with a strong positive PD-L1 expression had significantly worse OS than patients with a negative PD-L1 expression {hazard ratio (HR)=1.98; 95% CI, 1.21-3.24; p=0.006}. However, patients with a strong positive PD-L1 expression had a significantly better survival benefit from adjuvant chemotherapy (HR=0.43; p=0.03) compared with patients with a negative PD-L1 expression (HR=1.04; p=0.82).

      8eea62084ca7e541d918e823422bd82e Conclusion

      PD-L1 protein expression is not a prognostic marker, however it is a significant predictive marker of benefit from adjuvant chemotherapy in resected NSCLC.


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