Effect of Platinum-Based Chemotherapy on PD-L1 Expression on Tumor Cells in Non-small Cell Lung Cancer

• Published in: Cancer research and treatment Vol. 51; no. 3; pp. 1086 - 1097
• Main Authors: Shin, Junghoon, Chung, Jin-Haeng, Kim, Se Hyun, Lee, Kyu Sang, Suh, Koung Jin, Lee, Ji Yun, Kim, Ji-Won, Lee, Jeong-Ok, Kim, Jin-Won, Kim, Yu-Jung, Lee, Keun-Wook, Kim, Jee Hyun, Bang, Soo-Mee, Lee, Jong-Seok
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01-07-2019; 대한암학회
• Subjects: Adult; Aged; B7-H1 Antigen - metabolism; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - metabolism; Chemotherapy, Adjuvant; Female; Gene Expression Regulation, Neoplastic - drug effects; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - metabolism; Male; Middle Aged; Neoadjuvant Therapy; Original; Platinum - pharmacology; Platinum - therapeutic use; Prognosis; Retrospective Studies; Survival Analysis; Treatment Outcome; Up-Regulation; 의약학; Non-small cell lung carcinoma; PD-L1; Neoadjuvant therapy; Prognosis; Platinum
• ISSN: 1598-2998; 2005-9256
• DOI: 10.4143/crt.2018.537

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.
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.
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.
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.