Effect on Non-Small Cell Lung Cancer After Combination of Driver Gene Mutations and Anti-PD -1/PD-L1 Immunotherapy as Well as Chemotherapy

Zhengming Huang; Long Yu; Weisong Chen; Dan Zhu; Hui Chen

doi:10.18502/ijph.v53i8.16280

Zhengming Huang Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Zhejiang University, Zhejiang, China
Long Yu Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Zhejiang University, Zhejiang, China
Weisong Chen Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Zhejiang University, Zhejiang, China
Dan Zhu Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Zhejiang University, Zhejiang, China
Hui Chen Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Zhejiang University, Zhejiang, China

DOI: https://doi.org/10.18502/ijph.v53i8.16280

Keywords: Non-small cell lung cancer (NSCLC); Gene mutations; Prognostic analysis; Immunotherapy

Abstract

Background: We aimed to reveal the correlation between pathological indicators and PD-L1, between gene mutation status in lung cancer through clinico-pathological data and lung cancer-related gene mutation and PD-L1 expression analysis.

Methods: The study was conducted in . PD-L1 testing and targeted gene mutations detection were evaluated. The clinical characteristics of these non-small cell lung cancer (NSCLC) samples have been obtained. The groups were grouped according to clinico-pathological features and PD-L1 expression (Yes/No or High/Low), and the clinico-pathological and genetic and molecular features and correlation with PD-L1 expression were compared across the above groups. Comparisons and analyses were made between different treatment schemes.

Results: Lung adenocarcinoma (LUAD, n=142) and lung squamous carcinoma (LUSC, n=143) samples were enrolled (median age: 64 years old). Pleural invasion and M staging were significantly different from PD-L1 alterations (P<0.05). The percentage of patients with PD-L1 tumor proportion score (TPS)≥50% was 36.24% and the percentage of patients with PD-L1 TPS<50% was 29.53%. The percentage of patients with PD-L1 high-expressed and treated by immunotherapy was 75.93% and 63.41% experienced Partial Response/Complete Response. The mutations ratio of EGFR, ALK, KRAS, MET, RET and TP53 were 28.86%, 1.34%, 6.04%, 0.67%, 1.34% and 0.67%, respectively. KRAS mutation was significantly different from PD-L1 alterations (P<0.01).

Conclusion: There are individual differences in PD-L1 expression, which can also vary depending on the different clinical features. Specific molecular features correlate with differential PD-L1 expression and may influence the response to therapy.