PD-L1 is highly expressed in lung lymphoepithelioma-like carcinoma: A potential rationale for immunotherapy |
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| Affiliation: | 1. Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;2. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;3. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;4. Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan;5. National Taiwan University, Taipei, Taiwan;1. Department of Pulmonary Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands;2. Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands;1. University of Torino Italy, Torino, Italy;2. Unit of Cancer Epidemiology and CPO Piedmont, S. Giovanni Battista Hospital, Torino, Italy;3. Sapienza University of Rome, Fondazione Eleonora Lorillard Spencer Cenci, S. Andrea Hospital Rome, Italy;4. Catholic University “Sacred Heart” Rome, Rome, Italy;5. “Amedeo Avogadro” University Novara Italy, Novara, Italy;6. Sapienza University of Rome, Fondazione Eleonora Lorillard Spencer Cenci, Policlinico Umberto I Rome, Italy;7. University of Pisa Italy, Pisa, Italy;1. The 4th Department of Internal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China;2. Department of Oncological Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China;3. Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China;1. Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico;2. Dermatological Clinic, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico;3. Experimental Oncology Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico;4. Medicine School of Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico;1. Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK;2. Oncology, University Hospital of Herakleion, Herakleion, Crete, Greece;3. European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim, Norway;4. The Cancer Clinic, St. Olav''s Hospital, Trondheim University Hospital, Trondheim, Norway;5. Department of Surgical Sciences, University of Glasgow, Glasgow, UK;6. Larisa General Clinic, Thessaly, Greece |
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| Abstract: | ObjectivesProgrammed cell death-ligand 1 (PD-L1) and driver mutations are found in non-small cell lung cancers (NSCLCs) and may be suitable targets for specific therapies, but their roles in lymphoepithelioma-like carcinoma (LELC) of the lung are unclear.Materials and methodsSixty-six patients with pulmonary LELCs were investigated. Paraffin-embedded tumor sections were stained with PD-L1 antibody. Tumors with moderate-to-strong membrane staining in ≥5% of tumor cells were positive for PD-L1 overexpression. The presence of driver mutations in the genes for epidermal growth factor receptor (EGFR), KRAS, and BRAF were examined by direct sequencing. Anaplastic lymphoma kinase (ALK) and ROS1 levels were determined by immunohistochemistry. Correlations of PD-L1 expression and driver mutations with clinicopathologic parameters were analyzed.ResultsThe overall frequency of PD-L1 overexpression and EGFR mutation was 75.8% and 12.1%, respectively. No KRAS, BRAF, ALK or ROS1 aberrations could be detected. PD-L1 expression was not associated with driver mutations. Multivariate analysis revealed that smoking and advanced stage were independent risk factors for poor overall survival, whereas PD-L1 positivity was not significantly associated with patient outcome.ConclusionThere are high PD-L1 expression and infrequent driver mutations in LELCs compared with conventional NSCLCs. The high expression of PD-L1 in EBV and inflammation associated LELC may provide a rationale for immunotherapy in this subtype of lung cancer. |
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| Keywords: | Driver mutation Immunotherapy PD-L1 Pulmonary lymphoepithelioma-like carcinoma Lung cancer EGFR KRAS |
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