Prevalence of PD-L1 Expression in Patients with Advanced Non-Small Cell Lung Cancer Treated in Vajira Hospital
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Abstract
Objectives: Advanced non-small cell lung cancer (NSCLC) is one of the world-wide most common newly diagnosed cancer and cause of cancer deaths. Platinum-based chemotherapy was the backbone of management until an immune checkpoint inhibitor (ICI) as monotherapy or combination with chemotherapy is demonstrated survival benefits over chemotherapy. Program cell death ligand -1 (PD-L1) expression is still the best, even though not perfect biomarker of response to an ICI. This study was intended to determine the prevalence of PD-L1 expression among Thai advanced NSCLC patients.
Methods: The investigators performed a descriptive study of patients with advanced NSCLC who had formalin-fixed paraffin-embedded (FFPE) tissue specimens available, in January 1, 2016 to December 31, 2018, in the Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University. The baseline patients’ demographics were collected. The PD-L1 expression was determined by the PD-L1 IHC 22C3 pharmDx qualitative immunohistochemical assay. The primary endpoint was to assess the prevalence of PD-L1 expression (TPS >1%) among patients with advanced NSCLC. The secondary endpoints were to find out its correlation with demographics and independent factors of 1-year survival.
Results: There were 79 NSCLC patients who had FFPE tissue specimens available. However, only specimens from 35 patients had adequate quality for PD-L1 analysis. Only three of them (8.6%) had PD-L1 expression. No baseline demographics was associated with its expression. ECOG performance status was the only independent determining factor of 1-year survival. (SR 75.42, p-value < 0.001)
Conclusion: Unexpected low prevalence of PD-L1 expression was demonstrated. The inadequacy of tissue specimen would be the obstacle of PD-L1 analysis. The investigators remind the clinicians that the proper amounts of tumor samplings are suggested for further biomarker analysis.
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