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PD-L1 Expression in a Population with Non-Small Cell Lung Cancer in a Reference Healthcare Center in Latin-America
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A7344 - PD-L1 Expression in a Population with Non-Small Cell Lung Cancer in a Reference Healthcare Center in Latin-America
Author Block: L. Fernandez1, V. Zuñiga2, J. F. Henao3, L. F. Sua Villegas4, Biomedical Research Group in Thorax; 1Interventional Pulmonology, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 2Medical Student, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 3Internal Medicine, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 4Department of Pathology and Laboratory Medicine, Fundacion Valle Del Llil, Universidad Icesi, Calli, Colombia.
RATIONALES Non-small cell lung cancer (NSCLC) is the most common type among malignancies of the lung, and among its histological subtypes, different mutations and protein expressions have been object of study for the past years. Epidermal growth factor receptor (EGFR) mutations and EML4-ALK fusion as driver mutations have been reported to upregulate programmed death-ligand 1 (PD-L1) expression. Despite therapeutic significance of these associations has not been yet completely elucidated, studying the prevalence and correlation of these features becomes more important with time. METHODS Clinical and mutational features were described in 114 patients diagnosed with NSCLC between 2013 and 2016 at a reference health care center in Colombia. Among the patients in whom PD-L1 expression was tested, we reported its prevalence and distribution in patients positive for EGFR and ALK. RESULTS The mean age was 65 ± 12 years. 72.8% (n=83) were classified as stage IV. Adenocarcinoma was the most frequent (80.7%; n=92). The prevalence for EGFR mutations was 27% (n=30) and for EML4-ALK fusion gene was 15.8% (n=9). PD-L1 expression was tested in 57 patients from which 35% (n=20) came positive, 5 were also positive for EGFR and 4 for ALK. From all PD-L1 positives, 60% (n=12) with high expression. No association was found between gender and PD-L1 expression, and being a non-smoker was associated with a lower expression of the protein. CONCLUSION The prevalence of EGFR mutations was similar to that reported worldwide, and fusions in the EML4-ALK gene were higher than expected, as well as PD-L1 expression. Smoking has already been reported to be associated with a higher expression of PD-L1, as found in this study. More studies must be done regarding expression of the protein in patients with driver mutations to stablish reliable associations and elucidate the clinical significance of blocking PD-1/PD-L1 in EGFR and ALK-mutant NSCLC treated with TKIs.
Author Block: L. Fernandez1, V. Zuñiga2, J. F. Henao3, L. F. Sua Villegas4, Biomedical Research Group in Thorax; 1Interventional Pulmonology, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 2Medical Student, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 3Internal Medicine, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 4Department of Pathology and Laboratory Medicine, Fundacion Valle Del Llil, Universidad Icesi, Calli, Colombia.
RATIONALES Non-small cell lung cancer (NSCLC) is the most common type among malignancies of the lung, and among its histological subtypes, different mutations and protein expressions have been object of study for the past years. Epidermal growth factor receptor (EGFR) mutations and EML4-ALK fusion as driver mutations have been reported to upregulate programmed death-ligand 1 (PD-L1) expression. Despite therapeutic significance of these associations has not been yet completely elucidated, studying the prevalence and correlation of these features becomes more important with time. METHODS Clinical and mutational features were described in 114 patients diagnosed with NSCLC between 2013 and 2016 at a reference health care center in Colombia. Among the patients in whom PD-L1 expression was tested, we reported its prevalence and distribution in patients positive for EGFR and ALK. RESULTS The mean age was 65 ± 12 years. 72.8% (n=83) were classified as stage IV. Adenocarcinoma was the most frequent (80.7%; n=92). The prevalence for EGFR mutations was 27% (n=30) and for EML4-ALK fusion gene was 15.8% (n=9). PD-L1 expression was tested in 57 patients from which 35% (n=20) came positive, 5 were also positive for EGFR and 4 for ALK. From all PD-L1 positives, 60% (n=12) with high expression. No association was found between gender and PD-L1 expression, and being a non-smoker was associated with a lower expression of the protein. CONCLUSION The prevalence of EGFR mutations was similar to that reported worldwide, and fusions in the EML4-ALK gene were higher than expected, as well as PD-L1 expression. Smoking has already been reported to be associated with a higher expression of PD-L1, as found in this study. More studies must be done regarding expression of the protein in patients with driver mutations to stablish reliable associations and elucidate the clinical significance of blocking PD-1/PD-L1 in EGFR and ALK-mutant NSCLC treated with TKIs.
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