Tuberc Respir Dis.  2019 Jul;82(3):227-233. 10.4046/trd.2018.0070.

Clinical Characteristics of Korean Patients with Lung Cancer Who Have Programmed Death-Ligand 1 Expression

Affiliations
  • 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. droij@jnu.ac.kr
  • 2Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 3Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.

Abstract

BACKGROUND
Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD-1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer.
METHODS
We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays.
RESULTS
From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ≥1% and ≥50%, respectively. The patients were significantly older in TPS ≥1% group than in TPS <1% group (64.83±9.38 years vs. 61.73±10.78 years, p=0.014), not in TPS ≥50% cutoff value (64.69 ± 9.39 vs. 62.36 ± 10.51, p= 0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ≥1% (40.8% vs. 25.8%, p=0.020) and TPS ≥50% groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ≥1% (r=0.826; 95% confidence interval, 0.736-0.916).
CONCLUSION
PD-L1 expression, defined as TPS ??%, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.

Keyword

Asian Continental Ancestry Group; Patients; Lung Neoplasms; Gene Expression; Carcinoma, Non-Small-Cell Lung

MeSH Terms

Adenocarcinoma
Asian Continental Ancestry Group
Carcinoma, Non-Small-Cell Lung
Gene Expression
Humans
Immunohistochemistry
Lung Neoplasms*
Lung*
Retrospective Studies

Figure

  • Figure 1 Prevalence of programmed death-ligand 1 (PD-L1) expression using two cutoff points, in all patients. (A) The rate of PD-L1 expression was 42% with cutoff Tumor Proportion Score (TPS) 1%. (B) The rate of PD-L1 expression was 21% with cutoff TPS 50%. PD-1: programmed death-1.

  • Figure 2 Prevalence of programmed death-ligand 1 (PD-L1) expression using the 22C3 pharmDx and SP263 assays. (A) Among the 34 patients analyzed with both the 22C3 and SP263 assays, 27 patients gave positive PD-L1 results for both tests, with a cutoff of Tumor Proportion Score (TPS) ≥1%. (B) Those positive results were found for 20 patients, with a cutoff of TPS ≥ 50%.

  • Figure 3 Relationship between programmed death-ligand 1 (PD-L1) immunohistochemical 22C3 pharmDx and SP263 assay. (A) Scatter diagrams illustrating the relationship between expression levels with respect to 22C3 pharmDx and SP263 assays. Each point in the diagram indicates the percentage of positive tumor cells in the 22C3 (x-axis) and SP263 (y-axis) assays. A significantly high relationship was observed between the 22C3 and SP263 assays (r=0.826; 95% confidence interval, 0.736-0.916). (B) Analytic comparison of the percentage of tumor proportion score by case for each assay. Data points expressed the scores on each case (blue points for 22C3 pharmDx and red points for SP263 assay).


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