PD-1 and PD-L1 expression in molecularly selected non-small-cell lung cancer patients.
By: A D'Incecco, M Andreozzi, V Ludovini, E Rossi, A Capodanno, L Landi, C Tibaldi, G Minuti, J Salvini, E Coppi, A Chella, G Fontanini, M E Filice, L Tornillo, R M Incensati, S Sani, L Crinò, L Terracciano, F Cappuzzo

Department of Medical Oncology, Istituto Toscano Tumori, Civil Hospital, Viale Alfieri 36, 57124 Livorno, Italy.
2014-9-17; doi: 10.1038/bjc.2014.555
Abstract

Background:Agents targeting programmed death-1 receptor (PD-1) and its ligand (PD-L1) are showing promising results in non-small-cell lung cancer (NSCLC). It is unknown whether PD-1/PD-L1 are differently expressed in oncogene-addicted NSCLC.Methods:We analysed a cohort of 125 NSCLC patients, including 56 EGFR mutated, 29 KRAS mutated, 10 ALK translocated and 30 EGFR/KRAS/ALK wild type. PD-L1 and PD-1 expression were assessed by immunohistochemistry. All cases with moderate or strong staining (2+/3+) in >5% of tumour cells were considered as positive.Results:PD-1 positive (+) was significantly associated with current smoking status (P=0.02) and with the presence of KRAS mutations (P=0.006), whereas PD-L1+ was significantly associated to adenocarcinoma histology (P=0.005) and with presence of EGFR mutations (P=0.001). In patients treated with EGFR tyrosine kinase inhibitors (N=95), sensitivity to gefitinib or erlotinib was higher in PD-L1+ vs PD-L1 negative in terms of the response rate (RR: P=0.01) time to progression (TTP: P<0.0001) and survival (OS: P=0.09), with no difference in PD1+ vs PD-1 negative. In the subset of 54 EGFR mutated patients, TTP was significantly longer in PD-L1+ than in PD-L1 negative (P=0.01).Conclusions:PD-1 and PD-L1 are differentially expressed in oncogene-addicted NSCLC supporting further investigation of specific checkpoint inhibitors in combination with targeted therapies.British Journal of Cancer advance online publication 28 October 2014; doi:10.1038/bjc.2014.555 www.bjcancer.com.





PMID:25349974






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