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. 2020 Dec 3;10(1):21063.
doi: 10.1038/s41598-020-78152-1.

ALK variants, PD-L1 expression, and their association with outcomes in ALK-positive NSCLC patients

Gee-Chen Chang  1   2   3   4   5   6 , Tsung-Ying Yang  1   2 , Kun-Chieh Chen  1   4   5   6   7 , Kuo-Hsuan Hsu  8 , Yen-Hsiang Huang  1   3 , Kang-Yi Su  9   10 , Sung-Liang Yu  9   10   11   12   13 , Jeng-Sen Tseng  14   15   16
Affiliations

ALK variants, PD-L1 expression, and their association with outcomes in ALK-positive NSCLC patients

Gee-Chen Chang et al. Sci Rep. .

Abstract

It remains unclear how programmed death-ligand 1 (PD-L1) expression interacts with anaplastic lymphoma kinase (ALK) mutation, its variants, and the outcome of treatment. One hundred and twenty four out of 1255 patients (9.9%) were deemed ALK-positive by the Ventana IHC assay. PD-L1 status and ALK variants were available in 100 and 59 patients, respectively. PD-L1 positive (TPS ≥ 1%) and strong positive (TPS ≥ 50%) rate was 50% and 16%, respectively. A total of 64 variant types were detected in 59 patients. V1 (32.8%) and V3a/b (28.1%) were the most common variants. There was no significant association between ALK variants and the PD-L1 expression. The presence of V3a/b subtype independently predicted a worse overall survival in patients receiving ALK inhibitor(s) (aHR 5.10 [95% CI 1.22-21.25], P = 0.025) and platinum plus pemetrexed (aHR 9.62 [95% CI 1.90-48.80], P = 0.006). While incorporating ALK variants and PD-L1 expression together, patients with non-V3a/b/positive PD-L1 showed a trend towards longer OS. In conclusion, ALK-positive NSCLC patients possess a high PD-L1 expression rate. Although there was no significant association between PD-L1 expression and ALK variants, the outcome of ALK-positive patients could be sorted by these two biomarkers.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Association between cigarette smoking dose and ALK mutation (N, total cases; n, ALK-positive patients).
Figure 2
Figure 2
PD-L1 status and ALK variants in ALK-positive NSCLC patients (aTotal 64 variants were detected in 59 patients; bPatients with complex variants were categorized in the others).
Figure 3
Figure 3
Impact of ALK variants on the overall survival of ALK inhibitor(s) (a) and platinum plus pemetrexed (b) treatment.
Figure 4
Figure 4
Impact of ALK variants and PD-L1 expression status on the overall survival of patients receiving ALK inhibitor(s).
See this image and copyright information in PMC

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