Prognostic Significance of PD-L1 in Patients with Non-Small Cell Lung Cancer: A Large Cohort Study of Surgically Resected Cases.
The aim of our analysis was to evaluate the prognostic effect of programmed cell death ligand-1 (PD-L1) expression in patients with non-small cell lung cancer (NSCLC).



PD-L1 expression among 1070 surgically resected NSCLC specimens was evaluated by immunohistochemical analysis. Data were analyzed using Cox proportional hazard models adjusting for age, sex, smoking status, histologic type, stage, and performance status.



Sixty-eight patients (6%) were strongly PD-L1 positive and 410 (38%) were weakly PD-L1 positive. A significantly higher prevalence of PD-L1 positivity was observed among patients with squamous cell carcinoma and among stage IIIB and IV patients. PD-L1 expression may be associated with poorer overall survival, with an adjusted hazard ratio of 1.56 (95% confidence interval [CI]: 1.08-2.26, p = 0.02) for strong PD-L1 positivity, 1.18 (95% CI: 0.96-1.46; p = 0.12) for weak PD-L1 positivity, and 1.23 (95% CI: 1.00-1.51; p = 0.05) for the combined strongly and weakly positive groups compared with PD-L1 negativity. Negative prognostic effect of PD-L1 expression was not statistically significant after adjustment for postoperative chemotherapy or radiotherapy. Similar results were observed for progression-free survival. Among stage I patients, the disease recurrence rate was higher in the PD-L1-positive versus in the PD-L1-negative group (48% versus 27%, p < 0.001), with an adjusted hazard ratio for disease-free survival of 2.01 (95% CI, 1.08-3.73; p = 0.03) for strong PD-L1 positivity and 1.57 (95% CI, 1.17-2.11; p = 0.003) for weak PD-L1 positivity compared with PD-L1 negativity.



Tumor PD-L1 expression may be associated with poor prognosis in patients with NSCLC, although its significance weakens when postoperative therapy is considered.
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jong-Mu
JM
Sun
Merck & Co., Inc., Kenilworth, New Jersey.
Wei
W
Zhou
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Yoon-La
YL
Choi
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
So-Jung
SJ
Choi
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Se Eun
SE
Kim
Merck & Co., Inc., Kenilworth, New Jersey.
Zhen
Z
Wang
Merck & Co., Inc., Kenilworth, New Jersey.
Marisa
M
Dolled-Filhart
Merck & Co., Inc., Kenilworth, New Jersey.
Kenneth
K
Emancipator
Merck & Co., Inc., Kenilworth, New Jersey.
Dianna
D
Wu
Merck & Co., Inc., Kenilworth, New Jersey.
Russell
R
Weiner
QualTek Molecular Laboratories, Newtown, Pennsylvania.
D
D
Frisman
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hong Kwan
HK
Kim
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Yong Soo
YS
Choi
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Young Mog
YM
Shim
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: jhingookkim@gmail.com.
Jhingook
J
Kim
D000328:Adult; D000368:Aged; D060890:B7-H1 Antigen / Q000032:analysis*; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry* / Q000401:mortality / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis
D060890:B7-H1 Antigen; C423236:CD274 protein, human
Immunomodulation; Laboratory correlates; Molecular diagnosis and prognosis; PD-L1