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Characteristics and Predictive Value of PD-L1 Status in Real-World Non-Small Cell Lung Cancer Patients.
Tseng, Jeng-Sen; Yang, Tsung-Ying; Wu, Chih-Ying; Ku, Wen-Hui; Chen, Kun-Chieh; Hsu, Kuo-Hsuan; Huang, Yen-Hsiang; Su, Kang-Yi; Yu, Sung-Liang; Chang, Gee-Chen.
Afiliação
  • Tseng JS; Departments of Internal Medicine, Division of Chest Medicine.
  • Yang TY; Faculty of Medicine, School of Medicine, National Yang-Ming University.
  • Wu CY; Departments of Internal Medicine, Division of Chest Medicine.
  • Ku WH; Faculty of Medicine, School of Medicine, National Yang-Ming University.
  • Chen KC; Institute of Biomedical Sciences, National Chung Hsing University.
  • Hsu KH; Pathology and Laboratory Medicine, Taichung Veterans General Hospital.
  • Huang YH; Taipei Institute of Pathology.
  • Su KY; Departments of Internal Medicine, Division of Chest Medicine.
  • Yu SL; Institute of Biomedical Sciences, National Chung Hsing University.
  • Chang GC; Internal Medicine, Division of Critical Care and Respiratory Therapy.
J Immunother ; 41(6): 292-299, 2018.
Article em En | MEDLINE | ID: mdl-29683890
Immunotherapy targeting the programmed cell death-1 (PD-1) and programmed cell death-ligand 1 (PD-L1) pathway has emerged as an effective treatment for lung cancer patients. It is important to evaluate the practicality of PD-L1 testing in real-world practice. A total of 211 non-small cell lung cancer patients were enrolled to detect 5 driver mutations and PD-L1 status (22C3 and SP263 assays) and to evaluate the characteristics of PD-L1 expression and its predictive value of immunotherapy. The PD-L1 positive (≥1%) and strong positive (≥50%) rate by SP263 assay was 27.0% and 12.8%. The concordance rates between 2 PD-L1 assays while using 1%, 10%, 25%, and 50% positive tumor cells as the cutoffs were 76.8%, 81.5%, 90.5%, and 94.3%, respectively. Smokers and patients without known actionable driver mutation were more likely to present strong positive PD-L1 [adjusted hazard ratio, 5.00 (95% confidence interval-CI, 1.60-15.64); P=0.006 and 3.59 (95% CI, 1.25-10.33); P=0.018, respectively]. Higher levels of smoking were associated with higher PD-L1 expressions. None of the EGFR, ALK, HER2, or BRAF-mutant nonsmokers displayed strong positive PD-L1 expression by SP263 assay. Among patients undergoing PD-1 checkpoint inhibitors therapy, high PD-L1 expression by SP263 was associated with a longer progression-free survival [adjusted hazard ratio, 0.15 (95% CI, 0.03-0.71); P=0.017]. In conclusion, our results suggest that PD-L1 status remains an important predictor of immunotherapy efficacy. The concordance between 22C3 and SP263 assays was greater at a higher cutoff level of positivity. Patients without known actionable driver mutation, along with smokers, particularly those having high smoking pack-years, were more likely to have strong PD-L1 expression.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Antígeno B7-H1 / Imunoterapia / Neoplasias Pulmonares / Mutação Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Immunother Assunto da revista: ALERGIA E IMUNOLOGIA / NEOPLASIAS / TERAPEUTICA Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Antígeno B7-H1 / Imunoterapia / Neoplasias Pulmonares / Mutação Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Immunother Assunto da revista: ALERGIA E IMUNOLOGIA / NEOPLASIAS / TERAPEUTICA Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos