Highlights
- •There was a trend for poor survival in stage III non-small cell lung cancer who expressed programmed cell death-ligand 1 (PD-L1).
- •A combination of lack of PD-L1 expression and CD8+ tumour-infiltrating lymphocyte (TIL) density tended to predict favourable survival.
- •PD-L1 in combination with CD8+ TIL could be a useful predictive biomarker.
Abstract
Background
Expression of programmed cell death-ligand 1 (PD-L1) is known to be a mechanism whereby
cancer can escape immune surveillance, but little is known about factors predictive
of efficacy in patients with locally advanced non-small cell lung cancer (NSCLC).
We investigated the predictive relevance of PD-L1 expression and CD8+ tumour-infiltrating
lymphocytes (TILs) density in patients with locally advanced NSCLC receiving concurrent
chemoradiotherapy (CCRT).
Methods
We retrospectively reviewed 74 consecutive patients with stage III NSCLC who had received
CCRT. PD-L1 expression and CD8+ TIL density were evaluated by immunohistochemical
analysis.
Results
Univariate and multivariate analyses demonstrated that CD8+ TIL density was an independent
and significant predictive factor for progression-free survival (PFS) and OS, whereas
PD-L1 expression was not correlated with PFS and OS. Sub-analysis revealed that the
PD-L1+/CD8 low group had the shortest PFS (8.6 months, p = 0.02) and OS (13.9 months, p = 0.11), and that the PD-L1-/CD8 high group had the longest prognosis (median PFS
and OS were not reached) by Kaplan-Meier curves of the four sub-groups.
Conclusions
Among stage III NSCLC patients who received CCRT, there was a trend for poor survival
in those who expressed PD-L1. Our analysis indicated that a combination of lack of
PD-L1 expression and CD8+ TIL density was significantly associated with favourable
survival in these patients. It is proposed that PD-L1 expression in combination with
CD8+ TIL density could be a useful predictive biomarker in patients with stage III
NSCLC.
Keywords
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Article info
Publication history
Published online: January 06, 2016
Accepted:
November 19,
2015
Received in revised form:
October 26,
2015
Received:
August 27,
2015
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.