Research Papers:

The association between PD-L1 and EGFR status and the prognostic value of PD-L1 in advanced non-small cell lung cancer patients treated with EGFR-TKIs

Yanna Tang, Wenfeng Fang, Yaxiong Zhang, Shaodong Hong, Shiyang Kang, Yue Yan, Nan Chen, Jianhua Zhan, Xiaobo He, Tao Qin, Ge Li, Wenyi Tang, Peijian Peng and Li Zhang _

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Oncotarget. 2015; 6:14209-14219. https://doi.org/10.18632/oncotarget.3694

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Yanna Tang1,2,3,*, Wenfeng Fang1,2,3,*, Yaxiong Zhang1,2,3,*, Shaodong Hong1,2,3, Shiyang Kang1,2,3, Yue Yan1,2,3, Nan Chen1,2,3, Jianhua Zhan1,2,3, Xiaobo He1,2,3, Tao Qin1,2,3, Ge Li4, Wenyi Tang5, Peijian Peng5 and Li Zhang1,2,3

1 Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China

2 State Key Laboratory of Oncology in South China, Guangzhou, China

3 Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

4 Key Laboratory for Stem Cells and Tissue Engineering, Sun Yat-sen University, Guangzhou, China

5 Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhu Hai, China

* These authors have contributed equally to this work

Correspondence to:

Li Zhang, email:

Peijian Peng, email:

Keywords: NSCLC, PD-L1, EGFR status, TKI, prognosis

Received: January 08, 2015 Accepted: March 01, 2015 Published: March 29, 2015


Backgrounds: Recent clinical trials have shown that immune-checkpoint blockade yields remarkable response in a subset of non–small cell lung cancer (NSCLC) patients. However, few studies directly focus on the association between epidermal growth factor receptor (EGFR) mutational status and programmed cell death-ligand 1 (PD-L1) expression. We examined whether PD-L1 is related to clinicopathologic factors and prognosis in patients with advanced NSCLC treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs).

Methods: One-hundred and seventy patients with advanced NSCLC were explored. Paraffin-embedded tumour sections were stained with PD-L1 antibody. EGFR mutation was examined by fluorescent quantitative polymerase chain reaction (PCR). The correlations between PD-L1 expression and EGFR status and survival parameters were analyzed.

Results: The overall frequency of PD-L1 over-expression was 65.9% (112/170). In lung adenocarcinoma, PD-L1 tended to be associated with mutant EGFR (PD-L1 overexpression in mutant and wild-type EGFR, 64/89 (71.9%) vs. 32/56 (57.1%), respectively; p=0.067). Subgroup analyses showed that high PD-L1 expression was associated with significantly shorter overall survival (OS) in EGFR wild-type patients (p=0.029) but not in EGFR mutant patients (p=0.932) treated with EGFR-TKIs. Even more, for EGFR mutant patients, higher expression of PD-L1 might only signal better outcome with TKIs.

Conclusions: High PD-L1 expression was likely to be associated with the presence of EGFR mutation in advanced lung adenocarcinoma. For EGFR wild-type patients, the PD-L1 over expression can be considered as a poor prognostic indicator of OS.

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