Abstract
BackgroundSmall cell lung cancer (SCLC) is an aggressive malignancy with a distinct natural history and dismal prognosis. SCLC is characterized as a recalcitrant neoplasm with limited therapeutic options and platinum-based chemotherapy is the treatment of choice. Programmed cell death-ligand 1(PD-L1)-mediated immune escape may be a suitable target for specific therapy, but its role in SCLC is unclear.Materials and methodsIn total, 186 SCLC cases were investigated. Paraffin-embedded tumor sections were stained with a PD-L1 antibody. PD-L1 overexpression was denoted by moderate-to-strong PD-L1 membrane staining in ≥ 5% of tumor cells. Tumor cells and infiltrating lymphocytes were scored separately.ResultsThe overall frequency of PD-L1 overexpression, in tumor cells and tumor infiltrating lymphocytes (TILs) was 78.0% and 54.3%, respectively. High tumor PD-L1 expression was significantly correlated with high TIL PD-L1 expression (P=0.001) and stage IV disease (P=0.048). Multivariate analysis revealed that high tumor PD-L1 expression and stage IV disease were two independent risk factors for poor overall survival.ConclusionsHigh PD-L1 expression was observed in SCLCs compared with their expression in conventional NSCLCs. The aggressive behavior of SCLC could be partially related to PD-L1-mediated immune escape. High PD-L1 expression correlated with poor prognosis and may provide a rationale for immunotherapy for high-grade SCLC.
Highlights
Small cell lung cancer (SCLC) is an aggressive neuroendocrine cancer that secretes and responds to a wide variety of mitogenic peptide growth factors, SCLC accounts for 10-20% of all lung cancers [1]
High tumor PDL1 expression was significantly correlated with high tumor infiltrating lymphocytes (TILs) Programmed cell death ligand 1 (PD-L1) expression (P=0.001) and stage IV disease (P=0.048)
Multivariate analysis revealed that high tumor PD-L1 expression and stage IV disease were two independent risk factors for poor overall survival
Summary
Small cell lung cancer (SCLC) is an aggressive neuroendocrine cancer that secretes and responds to a wide variety of mitogenic peptide growth factors, SCLC accounts for 10-20% of all lung cancers [1]. It displays a distinct natural history with a high proliferative index and an unusually strong predilection for early metastasis [2]. These tumors are very sensitive to chemotherapy and radiotherapy, but are characterized by the relatively rapid appearance of chemo/radioresistance and relapses are common. Programmed cell death-ligand 1(PD-L1)-mediated immune escape may be a suitable target for specific therapy, but its role in SCLC is unclear
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