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Michael Phillip Zaleski
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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
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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.
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.
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