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M. Katsura



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    P1.07 - Immunology and Immunotherapy (ID 693)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P1.07-002 - The Expression of PD-L1 Protein as a Prognostic Factor in Lung Squamous Cell Carcinoma (ID 7345)

      09:30 - 09:30  |  Author(s): M. Katsura

      • Abstract
      • Slides

      Background:
      Programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1) pathway-targeted immunotherapy has become the standard option of care in the management of lung cancer. The expression of the PD-L1 protein in lung cancer is expected to be a prognostic factor or to predict the response to PD-1-blocking antibodies. However, the association between PD-L1 positivity and the clinicopathological features and patient outcomes in lung squamous cell carcinoma (SCC) remains unclear because the definitive cut-off value for the expression of PD-L1 protein remains to be established.

      Method:
      The expression of PD-L1 protein in 205 surgically resected primary lung SCC patients was evaluated by immunohistochemistry with the antibody clone SP142. We generated a histogram to show the proportion of PD-L1-positive carcinoma cells as described in the figure below, and set the cut-off values as 1%, 5%, 10% and 50%. Moreover, we examined the proliferative capacity of these tumors using Ki-67 immunohistochemistry.Figure 1



      Result:
      The samples from 106 (51.7%), 72 (35.1%), 61 (29.7%) and 37 (18.0%) patients were positive for the expression of PD-L1 protein at cut-off values of 1%, 5%, 10% and 50%, respectively. Fisher’s exact test showed that, for almost all of the factors, PD-L1 positivity was not associated with the clinicopathological features with any of the four cut-off values. Univariate and multivariate survival analyses revealed that the PD-L1-positive patients only had a poorer prognosis than the PD-L1-negative patients at the 1% cut-off value. The Ki-67 labeling index in the PD-L1-positive patients was higher than that in the PD-L1-negative patients.

      Conclusion:
      The expression of PD-L1 protein was associated with a poor prognosis in lung SCC patients. The 1% cut-off value for PD-L1 might become a better predictive marker than the other cut-off values, and notably, even minimal expression of PD-L1 protein may have a negative prognostic significance.

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    P3.16 - Surgery (ID 732)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.16-003 - The Clinical Significance of Immune-Nutritional Parameters in Surgically Resected Elderly Patients with Non-Small Cell Lung Cancer (ID 7403)

      09:30 - 09:30  |  Author(s): M. Katsura

      • Abstract
      • Slides

      Background:
      The world’s population is rapidly aging, and the age of patients with lung cancer will increase as well. The prognostic nutritional index (PNI), controlling nutritional status (CONUT), and the geriatric nutritional risk index (GNRI) are useful parameters for evaluating immune-nutritional status. We aimed to perform a multicenter retrospective study to investigate the correlations of these immune-nutritional parameters with postoperative comorbidities or surgical outcomes of elderly patients with non-small cell lung cancer (NSCLC).

      Method:
      We selected 272 consecutive patients with NSCLC aged >75 years treated from January 2005 to December 2012 and evaluate three preoperative immune-nutritional parameters as potential predictive factors of postoperative comorbidities or as prognostic factors for surgically resected elderly patients with NSCLC.

      Result:
      Both PNI and GNRI as well as sex and preoperative respiratory comorbidities, were significantly associated with postoperative comorbidities (P =0.0287, 0.0443, 0.0191 and 0.0177, respectively). Multivariate analyses showed that preoperative GNRI (P = 0.0161) as well as sex (P < 0.0001), preoperative serum carcino embryonic antigen levels (P = 0.0128), preoperative serum cytokeratin 19 fragment levels (P = 0.0125), pleural invasion (P = 0.0214) and lymphatic vessel invasion (P = 0.0165) significantly affected overall survival (OS). Abnormal GNRI was significantly associated with histology (P = 0.0419) and outcome (P =0.0077). In Kaplan–Meier analysis of OS by preoperative GNRI, the abnormal GNRI group had significantly shorter OS than the normal GNRI group (5-year OS, 45.15% vs. 64.10%, P = 0.0007, log-rank test). CONUT score did not have any correlation with postoperative comorbidities or surgical outcome.

      Conclusion:
      Preoperative GNRI is a novel preoperative predictor of postoperative comorbidities as well as a prognostic factor that may identify high-risk elderly patients with NSCLC.

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