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Published on: September 25, 2018
Effect of Platinum-Based Chemotherapy on PD-L1 Expression on Tumor Cells in Non-small Cell Lung Cancer
Junghoon Shin1, Jin-Haeng Chung2, Se Hyun Kim1
1Division of Hematology-Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Purpose:
Programmed death-1 (PD-1)/PD-1 ligand (PD-L1) axis blockades have revolutionized the treatment of advanced non-small cell lung cancer (NSCLC). We assessed the effect of platinum-based chemotherapy on tumor PD-L1 expression and its clinical implications.
Materials And Methods:
We used immunohistochemistry to retrospectively evaluate the percentage of tumor cells with membranous PD-L1 staining (tumor proportion score) in paired tumor specimens obtained before and after platinum-based neoadjuvant chemotherapy (NACT) in 86 patients with NSCLC. We analyzed the correlation between the change in PD-L1 tumor proportion score and clinicopathologic characteristics, response to NACT, and survival.
Results:
The PD-L1 tumor proportion score increased in a significant proportion of patients with NSCLC after platinum-based NACT (Wilcoxon signed-rank test, p=0.002). That pattern was consistent across clinically defined subgroups except for patients with partial response to NACT. Tumors from 26 patients (30.2%) were PD-L1‒negative before NACT but PD-L1-positive after NACT, whereas the reverse pattern occurred in six patients (7%) (McNemar's test, p < 0.001). Increase in PD-L1 tumor proportion score was significantly associated with lack of response to NACT (Fisher exact test, p=0.015). There was a tendency, albeit not statistically significant, for patients with an increase in PD-L1 tumor proportion score to have shorter survival.
Conclusion:
Tumor PD-L1 expression increased after platinum-based NACT in a significant proportion of patients with NSCLC. Increase in tumor PD-L1 expression may predict poor clinical outcome.
Insights
Platinum-based chemotherapy can increase programmed death-ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC) tumors. This increase may indicate a poor response to treatment and shorter survival in NSCLC patients.
Area of Science:
- Oncology
- Immunotherapy
- Cancer Research
Background:
- Programmed death-1 (PD-1)/PD-1 ligand (PD-L1) axis inhibitors have transformed advanced non-small cell lung cancer (NSCLC) treatment.
- Understanding how chemotherapy affects PD-L1 expression is crucial for optimizing treatment strategies.
Purpose of the Study:
- To assess the impact of platinum-based chemotherapy on tumor PD-L1 expression in NSCLC patients.
- To investigate the clinical implications of chemotherapy-induced changes in PD-L1 expression.
Main Methods:
- Retrospective analysis of 86 NSCLC patients undergoing platinum-based neoadjuvant chemotherapy (NACT).
- Immunohistochemistry used to evaluate tumor PD-L1 expression (tumor proportion score) before and after NACT.
- Correlation analysis of PD-L1 score changes with clinicopathologic factors, treatment response, and survival.
Main Results:
- A significant increase in tumor PD-L1 expression was observed after platinum-based NACT (p=0.002).
- 30.2% of tumors became PD-L1 positive after NACT, while 7% became negative (p < 0.001).
- Increased PD-L1 expression correlated with a lack of response to NACT (p=0.015) and showed a trend towards shorter survival.
Conclusions:
- Platinum-based NACT significantly increases tumor PD-L1 expression in a substantial portion of NSCLC patients.
- Elevated PD-L1 expression post-NACT may serve as a predictive marker for poor clinical outcomes in NSCLC.
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