PD-L1 Expression Is Associated With VEGFA and LADC Patients' Survival.

Shaochuan Liu,Tingting Qin,Yanan Jia,Kai Li

doi:10.3389/fonc.2019.00189

Shaochuan Liu, Tingting Qin + Show 2 more

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https://doi.org/10.3389/fonc.2019.00189

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Abstract

Objectives: To elucidate the relationship between VEGFA and PD-L1 expression in lung adenocarcinoma (LADC).Methods: PD-L1 and VEGFA expression were determined by immunohistochemistry with H-score on formalin-fixed paraffin-embedded resected LADC specimens of 129 cases.Results: High PD-L1 expression in 53 (41.1%) patients, high VEGFA expression in 65 (50.4%), and co-expression in 18 (14.0%) were observed. Inverse correlation between expression of PD-L1 and VEGFA was found (P = 0.002, r = −0.274). VEGFA and PD-L1 expression were not significantly associated with the clinicopathological features. High PD-L1 expression was significantly association with all patients' poor progression-free survival and overall survival in a univariate analysis, but there was no significantly association with high VEGFA expression and prognosis. Co-expression of PD-L1 and VEGFA exhibited a worst overall survival compared to negative groups (P = 0.005).Conclusions: These findings indicate that high PD-L1 expression could impact both poor overall survival and progression-free survival in patients with resected LADC. Co-expression of PD-L1 and VEGFA may be considered as an important prognostic factor for patients with resected lung adenocarcinoma.

Highlights

Lung cancer is the most common and deadliest cancer worldwide [1]
We retrospectively reviewed on the data of patients with resected tissue of lung adenocarcinoma (LADC) and investigated the relationship between PD-L1 and VEGFA expression to further explore their potential efficacy-predictive value in anti-angiogenic therapy with immunotherapy and their prognostic significance
Baseline clinic-pathological characteristics of 129 LADC cases were summarized in Table 1. 61 (52.7%) patients were male; 25 (19.4%) patients were above age of 65; 57 (44.2%) patients were smokers; 92 (71.3%) patients were diagnosed as stage I/II; 41 (31.8%) cancer were characterized as acinar adenocarcinoma; high PD-L1 expression in 53 (41.1%) patients; high VEGFA expression in 65 (50.4%); 56 (43.4%) patients had EGFR mutations and 17 (12.2%) patients had other mutations including KRAS mutations and ALK mutations; 29 (38.2%) cases were in VEGFA-&PD-L1- group, 47 (61.8%) were in VEGFA+&PDL1- group, 35 (66.0%) were in VEGFA-&PD-L1+ group and 18 (34.0%) were in VEGFA+&PD-L1+ group

Summary

Introduction

Non-small-cell lung cancer (NSCLC) accounts for approximately 80% of all patients, in which lung adenocarcinoma (LADC) is the most common. Increased PD-L1 enhances tumor immune evasion and has been reported to be associated with a poor survival in various malignancies including lung cancer [4]. With the development of anti-PD-1/PD-L1 inhibitors (such as nivolumab, pembrolizumab, ipilimumab), some clinical studies [5,6,7,8] have demonstrated excellent efficacy in patients with LADC, even in some with EGFR or ALK tyrosine kinase inhibitors (TKIs) resistance. It was found that high PD-L1 expression was closely correlated to a higher likelihood of objective response (OR) of anti-PD-1/PD-L1 in many studies [9, 10]

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