Abstract

BackgroundThe role of MET amplification in lung cancer, particularly in relation to checkpoint inhibition and EGFR WT, has not been fully explored. In this study, we correlated PD-L1 expression with MET amplification and EGFR, KRAS, or TP53 mutation in primary lung cancer.MethodsIn this retrospective study, tissue collected from 471 various tumors, including 397 lung cancers, was tested for MET amplification by FISH with a MET/centromere probe. PD-L1 expression was evaluated using clone SP142 and standard immunohistochemistry, and TP53, KRAS, and EGFR mutations were tested using next generation sequencing.ResultsOur results revealed that PD-L1 expression in non-small cell lung cancer is inversely correlated with EGFR mutation (P=0.0003), and positively correlated with TP53 mutation (P=0.0001) and MET amplification (P=0.004). Patients with TP53 mutations had significantly higher MET amplification (P=0.007), and were more likely (P=0.0002) to be EGFR wild type. There was no correlation between KRAS mutation and overall PD-L1 expression, but significant positive correlation between PD-L1 expression and KRAS with TP53 co-mutation (P=0.0002). A cut-off for the ratio of MET: centromere signal was determined as 1.5%, and 4% of lung cancer patients were identified as MET amplified.ConclusionsThis data suggests that in lung cancer both MET and TP53 play direct roles in regulating PD-L1 opposing EGFR. Moreover, KRAS and TP53 co-mutation may cooperate to drive PD-L1 expression in lung cancer. Adding MET or TP53 inhibitors to checkpoint inhibitors may be an attractive combination therapy in patients with lung cancer and MET amplification.

Highlights

  • In 2017, there will be approximately 220,000 new cases of lung cancer in the United States with approximately 160,000 deaths [1]

  • Our results revealed that PD-L1 expression in non-small cell lung cancer is inversely correlated with epidermal growth factor receptor (EGFR) mutation (P=0.0003), and positively correlated with TP53 mutation (P=0.0001) and mesenchymal-epithelial transition factor (MET) amplification (P=0.004)

  • Improved understanding of the molecular signatures of non-small cell lung cancer (NSCLC) has led to the development of targeted therapeutics against epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), or anaplastic lymphoma kinase (ALK) alterations which can result in significant response and extended overall survival (OS)

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Summary

Introduction

In 2017, there will be approximately 220,000 new cases of lung cancer in the United States with approximately 160,000 deaths [1]. Platinum-based chemotherapy delivers a response rate of 20–35% and a median overall survival (OS) of 8–12 months in non-small cell lung cancer (NSCLC) [2, 3]. Improved understanding of the molecular signatures of NSCLC has led to the development of targeted therapeutics against epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), or anaplastic lymphoma kinase (ALK) alterations which can result in significant response and extended OS. A significant percentage of NSCLC patients do not have a targetable mutation. The blockade of immune checkpoints, through inhibition, such as programmed cell death (PD-1)/. The role of MET amplification in lung cancer, in relation to checkpoint inhibition and EGFR WT, has not been fully explored. We correlated PD-L1 expression with MET amplification and EGFR, KRAS, or TP53 mutation in primary lung cancer

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