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T. Fujii



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    P2.03b - Poster Session with Presenters Present (ID 465)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03b-085 - Programmed Cell Death Ligand 1 (PD-L1) Expression in Stage II and III Lung Adenocarcinomas (ID 4663)

      14:30 - 14:30  |  Author(s): T. Fujii

      • Abstract
      • Slides

      Background:
      Programmed cell death ligand 1 (PD-L1) expression could be used as a predictive marker for anti PD-1/PD-L1 therapy, especially for adenocarcinomas. However, the correlation between PD-L1 expression and the epidermal growth factor receptor (EGFR) mutational status has not been adequately studied. Additionally, whether PD-L1 positive expression is a prognostic factor or not is still debatable. We aimed to compare the clinicopathological findings including EGFR mutation and prognosis of stage II and III adenocarcinomas with positive or negative PD-L1 expression.

      Methods:
      Sixty-eight surgically resected stage II and III adenocarcinomas were included in this study. PD-L1 (clone SP142) expression was quantitatively assessed and considered to be positive when membranous staining of the tumor cells was >5%. Various clinicopathological parameters including pathologic findings were examined.

      Results:
      PD-L1 expression was positive in 11 of 68 (16.2%) adenocarcinomas. In the univariate analysis, PD-L1 positive expression was associated with abundant CD8+ lymphocytes (p<0.01), negative or unknown EGFR mutation (p=0.04), a predominant pathological pattern for adenocarcinoma based on the WHO 2015 classification (p=0.03), extracellular mucin production (p=0.05), and the presence of necrosis (p=0.01). Multivariate analysis showed that abundant CD8+ lymphocytes (p<0.01), a low N stage (p=0.05), and the presence of necrosis (p=0.054) were associated with PD-L1 positive expression. It also showed that PD-L1 positive expression was associated with longer RFS (p= 0.07, hazard ratio 6.21, 96% confidence interval 1.67-23.26). Abundant CD8+ lymphocytes and stage III adenocarcinoma were unfavorable factors for RFS. Figure 1



      Conclusion:
      According to the multivariate analysis, PD-L1 positive expression was associated with abundant CD8+ lymphocytes, a low N stage, and the presence of necrosis. Negative or unknown EGFR mutation was associated with PD-L1 positive expression according to the univariate analysis, but this association was not significant in the multivariate analysis. Regarding RFS, PD-L1 positive expression was a favorable prognostic factor independent of the surgical stage in the multivariate analysis.

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