吉非替尼
医学
免疫组织化学
肺癌
内科学
肿瘤科
FOXP3型
免疫系统
癌症
病理
表皮生长因子受体
癌症研究
免疫学
作者
Ji Sang Han,Dong‐Wan Kim,Jaemoon Koh,Bhumsuk Keam,Tae Min Kim,Yoon Kyung Jeon,Se‐Hoon Lee,Doo Hyun Chung,Dae Seog Heo
标识
DOI:10.1016/j.cllc.2015.11.006
摘要
Abstract
Introduction
Therapies targeting programmed cell death-1 (PD-1) and its ligand (PD-L1) have been successful in a subset of patients with non–small-cell lung cancer (NSCLC). PD-L1 expression in tumor tissues has been suggested as a predictive and prognostic marker. We examined the change in PD-L1 expression after gefitinib in patients with EGFR-mutant NSCLC. Materials and Methods
Paired tumor tissues were collected before and after gefitinib from 18 patients. PD-L1 expression on the tumor and immune cells was defined by the H-score of immunohistochemical staining (range, 0-300). The correlations between the change in PD-L1 expression and clinicopathologic characteristics were analyzed. Results
PD-L1 expression on tumor cells showed an increase in the median H-score from 25 to 40 (P = .067). Of the 18 patients, 7 (38.9%) had a marked increase in the median H-score (range, 80-180; group A) and 11 (61.1%) had no change in the median H-score (0 for both scores; group B). In groups A and B, the median progression-free survival for gefitinib was 13 and 12 months (P = .594), and the median overall survival was "not reached" and 38 months (P = .073), respectively. MET positivity by immunohistochemistry in biopsies after gefitinib therapy was significantly associated with group A (P = .028). The PD-L1 H-score by immunohistochemistry, but not by tumor cells, showed correlations with other immune cells; FOXP3+ expression in biopsies before gefitinib use, and PD-1+ and CD3+ in biopsies after gefitinib therapy, respectively. Conclusion
PD-L1 expression in tumor cells markedly increased in a subset of patients after gefitinib treatment. Thus, rebiopsy should be considered when using PD-L1 expression as a biomarker.
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