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J. Zhang
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P2.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 234)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.04-071 - PD-L1 Expression Is Not Associated with Disease-Free Survival in NSCLC Patients Who Underwent Radical Resection (ID 2856)
09:30 - 09:30 | Author(s): J. Zhang
- Abstract
Background:
The expression of Programmed Cell Death Ligand 1 (PD-L1), as a major mechanism of immune escape, has been observed in various malignancies. However, its prognostic impact on non-small cell lung cancer (NSCLC) patients remains controversial, especially those in early stage when theoretically all tumors have been removed. We sought to examine the correlation between PD-L1 expression and prognosis of NSCLC patients after radical resection.
Methods:
A consecutive cohort of 681 patients who underwent radical resection for stage I to III NSCLC in our center between Sep 2009 and Dec 2011 was collected. All available cancerous tissues were collected and were made into tissue arrays. Immunohistochemistry staining using PD-L1 (E1L3N ®) XP ® Rabbit mAb was performed to detect the PD-L1 expression. PD-L1 positive expression was denoted as more than 10% tumor cells with PD-L1 staining, while PD-L1 high expression was denoted as H score≥100. The primary endpoint was disease-free survival (DFS).
Results:
Tissues of 670 patients were available and all of them were eligible for PD-L1 staining. There were 222 events (recurrence/death) and the median follow-up was 3.1 year (range, 0.1 to 5.6). Neither positive expression (HR 0.93, 95%CI 0.69 to 1.25; P=0.61) nor high expression of PD-L1 (HR 0.88, 95% CI 0.59 to 1.31; P=0.54) was associated with DFS (Figure 1). The absence of discrepancies in prognosis did not differ in each stage and histology (Table 1). Figure 1 Figure 1. Kaplan-Meier curve. Table 1. Subgroup analysesSubgroup No. HR 95% CI Sig. Stage I 340 0.754 0.299 1.897 0.548 II 139 0.827 0.406 1.683 0.600 III 162 0.669 0.355 1.259 0.213 Histology Non-squamous without neuroendocrine differentiation 473 0.840 0.483 1.461 0.537 Squamous 146 0.867 0.445 1.690 0.675 Other or mix 49 0.763 0.225 2.585 0.664
Conclusion:
This large scale study showed that PD-L1 is not a prognostic factor in early stage NSCLC after radical resection. These results encourage us to investigate whether the nature of the disease especially regarding immune escape will change after radical resection.
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-014 - The Impact of Post-Operative Adjuvant Chemotherapy for Resected NSCLC in the Real-World Setting: Single Center Experience (ID 2905)
09:30 - 09:30 | Author(s): J. Zhang
- Abstract
Background:
Recent evidence argues against the benefits from adjuvant chemotherapy (ad-chemo) for resected NSCLC in the real world setting. We sought to examine the impact of ad-chemo based on the data from our center.
Methods:
A consecutive cohort of 681 patients who underwent radical resection for stage I to III NSCLC in our center between Sep 2009 and Dec 2011 was collected. Patients who received adjuvant EGFR-TKIs were excluded. Patients lost follow-up upon discharge (uncertain history of ad-chemo) were included in sensitivity analyses. The primary endpoint was disease-free survival (DFS).
Results:
372 patients received ad-chemo whereas 224 did not, and the remaining 85 had no certain record of ad-chemo. There were 222 events (175 recurrence and 47 deaths). Univariate analysis showed that patients who received ad-chemo had shorter DFS than those who did not (HR 1.94, 95%CI 1.40 to 2.67; P<0.001). Incorporation of those without certain record of ad-chemo (HR 1.88; P<0.001) or excluding patients with stage I disease (HR 1.36; P=0.17) did not alter the trend. After adjusting for some important prognostic factors, such as stage, histology, visceral-pleural invasion, the inferiority of ad-chemo remained. In ad-chemo arm, we observed potentially better DFS in patients receiving platinum-based regimen (HR 0.64, 95% CI 0.38 to 1.07; P=0.09) and patients complete 4 or more cycles of ad-chemo (HR 0.73, 95% CI 0.52 to 1.01; P=0.05).
Conclusion:
Current results suggested that applying adjuvant chemotherapy should be based on strict patient selection. Establishment of selection criteria regarding recurrence risk and physical status is highly encouraged.
