Investigation on the survival implications of PD-L1 expression status in ALK- rearranged advanced non-small cell lung cancer treated with first-line crizotinib.
Investigation on the survival implications of PD-L1 expression status in ALK- rearranged advanced non-small cell lung cancer treated with first-line crizotinib.
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DOI：
10.1016/j.lungcan.2022.04.002
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发表时间：
2022-04
期刊：
影响因子：
5.3
通讯作者：
Yuling Zhou;Lianxi Song;Qinqin Xu;L. Zeng;Wenjuan Jiang;N. Yang;Yongchang Zhang
中科院分区：
文献类型：
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作者：
Yuling Zhou;Lianxi Song;Qinqin Xu;L. Zeng;Wenjuan Jiang;N. Yang;Yongchang Zhang
背景程序性细胞死亡配体1（PD-L1）表达与克唑替尼治疗的间变性淋巴瘤激酶（ALK）重排非小细胞肺癌（NSCLC）患者的无进展生存期（PFS）较短相关。然而，PD-L1表达与ALK重排NSCLC总生存期（OS）之间的关系尚不清楚。在这项研究中，我们研究了基线PD-L1表达状态对接受克唑替尼治疗的ALK重排晚期NSCLC患者生存期的影响。我们回顾性分析了128例ALK患者组织样本的基线PD-L1表达水平，结果在分析的128例基线肿瘤标本中，（76.6%，n = 98）PD-L1低表达（肿瘤比例评分（TPS）< 50%），其中58.6%（n = 75）具有< 1%和18.0%（n = 23）具有1%-49%，其余23.4%（n = 30）为PD-L1高表达（TPS ≥ 50%）。高基线PD-L1表达与检查的任何临床特征无关。基线PD-L1表达水平高的患者（n = 30）的中位PFS显著较短（6 vs 11个月，p = 0.011）和OS（17 vs 53个月，p = 0.023）比PD-L1水平低的患者（n = 98）接受克唑替尼治疗。结论ALK重排的非小细胞肺癌患者的一个子集具有高基线PD-L1表达水平（TPS ≥ 50%）尽管接受克唑替尼治疗，但生存结局较差。我们的研究提出了研究替代治疗策略以改善该患者亚群生存结局的必要性。
BackgroundProgrammed cell death–ligand 1 (PD-L1) expression has been associated with shorter progression-free survival (PFS) of crizotinib-treated patients with anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC). However, the association between PD-L1 expression and overall survival (OS) inALK-rearranged NSCLC remains unclear. In this study, we investigated the survival implication of baseline PD-L1 expression status in crizotinib-treated patients withALK-rearranged advanced NSCLC.MethodsBetween October 1, 2015, and October 31, 2021, we retrospectively analyzed the baseline PD-L1 expression levels using immunohistochemistry 22C3 assay of tissue samples from 128 patients withALK-rearranged advanced lung adenocarcinoma who were treated with first-line crizotinib.ResultsOf the 128 baseline tumor specimens analyzed, a majority (76.6%, n = 98) had low PD-L1 expression (tumor proportion score (TPS) < 50%), wherein 58.6% (n = 75) had < 1% and 18.0% (n = 23) had 1%–49%, and the remaining 23.4% (n = 30) had high PD-L1 expression level (TPS ≥ 50%). High baseline PD-L1 expression was not associated with any clinical characteristic examined. Patients with high baseline PD-L1 (n = 30) expression level had significantly shorter median PFS (6 vs 11 months, p = 0.011) and OS (17 vs 53 months, p = 0.023) on crizotinib treatment than those with low PD-L1 level (n = 98).ConclusionsA subset of patients withALK-rearranged NSCLC having high baseline PD-L1 expression level (TPS of ≥ 50%) had poorer survival outcomes despite crizotinib therapy. Our study raises the need to investigate alternative treatment strategies to improve survival outcomes of this patient subset.