High PD-L1 Expression is Associated with Unfavorable Clinical Outcome in EGFR-Mutated Lung Adenocarcinomas Treated with Targeted Therapyopen access
- Authors
- Yoon, Byung Woo; Chang, Boksoon; Lee, Seung Hyeun
- Issue Date
- Aug-2020
- Publisher
- DOVE MEDICAL PRESS LTD
- Keywords
- lung cancer; programmed death-ligand 1; epidermal growth factor receptor mutation; tyrosine kinase inhibitor; clinical outcome; prognosis; T790M
- Citation
- ONCOTARGETS AND THERAPY, v.13, pp 8273 - 8285
- Pages
- 13
- Journal Title
- ONCOTARGETS AND THERAPY
- Volume
- 13
- Start Page
- 8273
- End Page
- 8285
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/73991
- DOI
- 10.2147/OTT.S271011
- ISSN
- 1178-6930
- Abstract
- Purpose: Although programmed death-ligand 1 (PD-L1) expression is widely accepted as a predictive and prognostic biomarker in immunotherapy, its implications in lung cancer patients with driving mutations are still unclear. The objective of this study is to determine the association between PD-L1 expression and treatment outcome in epidermal growth factor receptor (EGFR)-mutated lung cancer treated with tyrosine kinase inhibitors (TKIs). Methods: We retrospectively enrolled EGFR-mutant, advanced lung adenocarcinoma patients who received first-line EGFR-TKIs and evaluated the PD-L1 tumor proportion score (TPS) using the 22C3 pharmDx assay. We investigated the distribution of patients with different PD-L1 TPS values, followed by the analysis of response rate (RR), survival rate, and incidence of secondary T790M mutation according to the PD-L1 TPS group. Results: Among the 131 patients analyzed, the proportion of patients with PD-L1 TPS >= 50%, 1-49%, and <1%, was 17.6%, 32.8%, and 49.6%, respectively. The RR was significantly lower in the group with PD-L1 TPS >= 50% than in the other groups (43.5% vs 72.1% vs 78.5%, all p = 0.001). In multivariate analysis, PD-L1 TPS >= 50% was independently associated with a significantly shorter PFS in the overall population (hazard ratio [HR] = 2.64, p = 0.004) and associated with shorter OS in patients with exon 19 deletion (HR = 2.55, p = 0.041) compared with PD-L1 TPS < 50%. In addition, the frequency of secondary T790M mutation after TKI failure was significantly lower in the group with PD-L1 TPS >= 50% than in the other groups (13.3% vs 40.0% vs 53.3%, all p = 0.001). PD-L1 TPS >= 50% was an independent predictor of a lower frequency of this mutation (HR = 0.63, p = 0.043). Conclusion: High PD-L1 expression was associated with unfavorable clinical outcome and less development of secondary T790M mutation, suggesting a distinct subgroup warranting active surveillance and tailored therapeutic approach.
- Files in This Item
-
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/73991)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.