Prognostic Value of PD-L1 mRNA Sequencing Expression Profile in Non-Small Cell Lung Cancer.

Prognostic Value of PD-L1 mRNA Sequencing Expression Profile in Non-Small Cell Lung Cancer.

Ann Thorac Surg. 2018 Mar 03;:

Authors: Sepesi B, Nelson DB, Mitchell KG, Gibbons DL, Heymach JV, Vaporciyan AA, Swisher SG, Roszik J

Abstract
BACKGROUND: Immune checkpoint inhibitors targeting the PD-L1 pathway have shown benefit for the treatment of metastatic non-small cell lung cancer (NSCLC). However, the prognostic value of PD-L1 independent of immunotherapy is still unclear, with conflicting results reported between PD-L1 expression and patient survival. Our aim was to correlate PD-L1 mRNA level with clinical and pathologic factors and to investigative the prognostic value of PD-L1 mRNA in all stages of NSCLC.
METHODS: Gene expression and clinical data were obtained from public TCGA repositories from the National Cancer Institute. Genotype-Tissue Expression (GTEx) was used to compare with normal tissue expression analysis.
RESULTS: 985 patients met inclusion criteria, among whom 79.6% were stage I-II, 16.5% were stage III, and 3.5% were stage IV, representing N=495 adenocarcinoma and N=490 squamous cell carcinoma. PD-L1 mRNA gene expression in lung cancers was higher than in most other tumor and normal tissue types, and was significantly higher in lung SCC than adenocarcinoma (p<0.001). PD-L1 mRNA expression was associated with pathologic stage in squamous cell carcinoma and with smoking status in adenocarcinoma of the lung. However, none of the cutoff values of PD-L1 mRNA expression were prognostic of overall survival.
CONCLUSIONS: Our results suggest that the value of PD-L1 mRNA in prognosticating outcome in lung cancer is limited. Further studies are needed to identify novel prognostic biomarkers other than PD-L1 that are associated with improved patient survival. Identification of further prognostically important biomarkers may prove useful in identifying patients suitable for immunotherapy.

PMID: 29510096 [PubMed - as supplied by publisher]

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