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Xiao Fu



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    EP1.12 - Small Cell Lung Cancer/NET (ID 202)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-22 - The Expression and Prognostic Roles of PD-L1, PAPR1 and DLL3 in Small Cell Lung Cancer (Now Available) (ID 866)

      08:00 - 18:00  |  Author(s): Xiao Fu

      • Abstract
      • Slides

      Background

      Small cell lung cancer (SCLC) is an aggressive high-grade neuroendocrine tumor with limited treatment. Recently chemotherapy combined with anti-PD-L1 therapy was approved for SCLC. PARP1and DLL3 inhibitor are under clinical trials but the data revealed that these agents benefit a proportion of SCLC patients. Which patient can benefit from anti-PD-L1, PARP1 and DLL3 inhibitor therapy and whether combination of these agents can improve the survival of SCLC are unknown. We aim to examine the expression and prognostic roles of PD-L1, PARP1 and DLL3 and to analyze the correlation between them and clinicalpathological factors.

      Method

      All protocols were approved by the Ethics Committee of Xi'an Jiaotong University and informed consent was signed. FFPE samples were obtained from Department of Pathology at The First Affiliated Hospital of Xi'an Jiaotong University from 2011 to 2018. SCLC was confirmed in all patients by surgical pathology and graded by AJCC TNM staging system. The expression of PD-L1, PARP1 and DLL3 were detected by immunohistochemistry as previously described. The association between PD-L1, PARP1, DLL3 and clinicalpathological characteristics was performed by χ2 test. The survival curves were analyzed by the log-rank test and Cox proportional hazards model.

      Result

      Except for CYFRA21-1 and DLL3, no correlation between PD-L1, PARP1 and DLL3 and clinicalpathological factors were noticed (Table 1).

      Table 1. Correaltion between PD-L1, PARP1, DLL3 and clinialpathological factors in SCLC patients
      PD-L1 negative PD-L1 positive χ2 P PARP1 negative PARP1 positive χ2 P DLL3 negative DLL3 positive χ2 P
      Age
      <60 11 12 17 6 8 15
      >=60 8 13 0.42 0.56 17 3 0.80 0.74 7 11 0.07 0.79
      Gender
      Male 14 21 28 7 15 28
      Female 4 4 0.27 0.70 6 2 0.10 1.00 3 5 0.10 1.00
      Smoking status
      Smoker (including previous smoker) 12 15 23 4 10 17
      Never-smoker 6 10 0.20 0.76 11 5 1.64 0.26 5 11 0.15 0.70
      Central or Peripheral
      Central 11 16 21 6 10 17
      Peripheral 7 9 0.04 1.00 13 3 0.07 1.00 5 11 0.15 0.70
      CEA level
      CEA normal 9 12 16 5 7 14
      CEA high4 4 7 9 2 4 7
      Unknown 9 2 5.68 0.06 9 2 0.13 0.90 4 7 0.04 0.98
      CYFRA21-1 level
      CYFRA21-1 normal 7 11 14 4 5 13
      CYFRA21-1 high 5 7 9 3 9 3
      Unknown 6 7 0.16 0.92 11 2 0.03 0.83 4 9 7.54 0.02
      NSE level
      NSE normal 2 0 1 1 0 2
      NSE high 10 17 21 6 11 16
      Unknown 6 8 3.04 0.22 12 2 0.79 0.49 4 10 1.73 0.42
      TNM stage
      TNM stage 1-2 10 13 13 10 6 17
      TNM stage 3-4 7 12 0.19 0.66 16 3 3.73 0.05 9 11 1.69 0.19

      We also demonstrated that PD-L1 predicts poor prognosis (HR=0.26, P=0.01), while either PARP1 or DLL3 has no correaltion with prognosis in SCLC patients (HR=0.40, P=1.39 and HR=0.07, P=1.29 respectively).

      Interestingly, we found SCLC patients with negative PD-L1 and PARP1, negative PD-L1 and DLL3 performed the best survival (Figure 1).
      layout 1.jpg

      Figure 1. Overall survival of SCLC patients with different expression patterns of PD-L1 and PARP1, PD-L1 and DLL3.

      Conclusion

      PD-L1 is a negative prognositc factor in SCLC.

      Different expression pattern of PD-L1 and PARP1, PD-L1 and DLL3 lead to significantly different prognosis in SCLC.

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