Research Papers:

High PD-L1 expression is associated with stage IV disease and poorer overall survival in 186 cases of small cell lung cancers

Yih-Leong Chang _, Ching-Yao Yang, Yen-Lin Huang, Chen-Tu Wu and Pan-Chyr Yang

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Oncotarget. 2017; 8:18021-18030. https://doi.org/10.18632/oncotarget.14935

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Yih-Leong Chang1,3, Ching-Yao Yang2,3,*, Yen-Lin Huang1,*, Chen-Tu Wu1,3, Pan-Chyr Yang2,3,4

1Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan

2Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan

3Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 10002, Taiwan

4National Taiwan University, Taipei 10617, Taiwan

*These authors have contributed equally to this work

Correspondence to:

Chen-Tu Wu, email: [email protected]

Keywords: small cell lung cancer, immunotherapy, programmed cell-death ligand 1, stage, overall survival

Received: October 06, 2016    Accepted: December 27, 2016    Published: February 01, 2017


Background: Small 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 methods: In 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.

Results: The 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.

Conclusions: High 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.

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