Virtual Library

Start Your Search

Michael Phillip Zaleski



Author of

  • +

    P3.09 - Pathology (Not CME Accredited Session) (ID 975)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
    • +

      P3.09-07 - Immunohistochemical Expression of Programmed Death-Ligand 1 in Diabetic Patients vs Non-Diabetics with Non-Small Cell Lung Cancer  (ID 14142)

      12:00 - 13:30  |  Author(s): Michael Phillip Zaleski

      • Abstract

      Background

      Immunohistochemical (IHC) expression of programmed death-ligand 1 (PD-L1) serves as a predictive biomarker to select a subgroup of patients who may benefit from immunotherapy. Diabetes mellitus type 2 (DM2) has been shown to be present in approximately 20-25% of lung cancer patients and adversely affects lung cancer outcome. Yet, there are no established studies which investigate potential differences in PD-L1 expression in this group of patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      To investigate expression of PD-L1 in DM2 patients compared to non-DM2 patients, we assembled a retrospective cohort of 79 surgically-resected NSCLC cases (39-adenocarcinoma, 40-squamous cell carcinoma) without previous malignancies or pre-operative radiation. Clinical data were obtained by chart review. Patients with DM2 had Hb1Ac levels of 7.5-7.7. Histologic slides were methodically reviewed. PD-L1 (DAKO 22C3) immunohistochemistry was performed on slides with the maximum amount of viable tumor. Tumor positive score (TPS) was evaluated based on IASLC guidelines as follows: 0: no staining; 1: <1%; 2: 1-49%; and 3: >50%. Immunoreactivity was compared using Chi-square and Fisher’s exact tests.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 79 cases of NSCLC, 40 (50.6%) were patients with DM2, and consisted of 20 (50%) adenocarcinoma, and 20 (50%) squamous cell carcinoma. Non-DM2 patients showed a relatively equal TPS distribution from 0 to more than 50%; however, DM2 group largely showed TPS of less than 50% (P=0.0319 Chi-square test); (P=0.0347 Fisher's Exact test); (Table 1). No significant difference was observed between the two groups in terms of overall survival, local recurrence, metastasis, peritumoral inflammation, and necrosis.

      pd-l1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      DM2 patients were less likely to have PD-L1 >50%, and therefore they may be less likely to respond to PD-L1 inhibition alone in the adjuvant setting. These findings are in accordance with the literature that supports a worse prognosis, tendency for co-morbidities, and known immunologic defects for DM2 patients with NSCLC.

      6f8b794f3246b0c1e1780bb4d4d5dc53