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. 2022 Jun 13;12(1):9753.
doi: 10.1038/s41598-022-13102-7.

PD-L1 strong expressions affect the clinical outcomes of osimertinib in treatment naïve advanced EGFR-mutant non-small cell lung cancer patients

Kuo-Hsuan Hsu  1 , Jeng-Sen Tseng  2   3   4   5 , Tsung-Ying Yang  2   6 , Kun-Chieh Chen  7   8   9 , Kang-Yi Su  10   11 , Sung-Liang Yu  10   11   12   13   14   15 , Jeremy J W Chen  3 , Yen-Hsiang Huang  16   17   18 , Gee-Chen Chang  3   7   19
Affiliations

PD-L1 strong expressions affect the clinical outcomes of osimertinib in treatment naïve advanced EGFR-mutant non-small cell lung cancer patients

Kuo-Hsuan Hsu et al. Sci Rep. .

Abstract

The impact of strong Programmed Death-ligand 1 (PD-L1) expression on the clinical outcomes of osimertinib in treatment naïve advanced Epidermal Growth Factor Receptor (EGFR)-mutant Non-small Cell Lung Cancer (NSCLC) patients remains uncertain. We enrolled advanced NSCLC patients who harbored sensitizing EGFR mutation and were treated first-line with osimertinib between 2017 and 2021. The PD-L1 expression level was also tested. A total of 85 patients were included. The objective response rate to osimertinib was 78.9%, with the disease control rate being 90.8%. Median Progression-free Survival (PFS) was 22.1 months, while median Overall Survival (OS) was not reached (NR). Patients with the exon 19 deletion experienced better PFS than those with the exon 21 L858R mutation (NR vs 12.4 months, aHR 0.24 (95% CI, 0.10 to 0.57); p = 0.001). Seventy-one of these 85 patients had reported on their PD-L1 expression. Patients with a PD-L1 < 50% experienced longer PFS than patients with a PD-L1 ≧50% (26.5 vs 9.7 months, aHR 0.19 (95% CI, 0.06 to 0.67); p = 0.009). Additionally, patients with a PD-L1 < 50% experienced better OS than those with a PD-L1 ≧50% (NR vs 25.4 months, aHR 0.09 (95% CI, 0.01 to 0.70); p = 0.021). Strong expressions of PD-L1 in treatment naïve advanced EGFR-mutant NSCLC patients were associated with poor prognoses in those undergoing treatment with osimertinib as first-line therapy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The clinical efficacy of osimertinib in advanced EGFR-mutant NSCLC patients. (A) The median progression-free survival. (B) The median overall survival. EGFR, epidermal growth factor receptor; NSCLC, non-small-cell lung cancer
Figure 2
Figure 2
The clinical efficacy of osimertinib in patients with PD-L1 expression reports. (A) The median PFS. (B) The median OS. (C) The median PFS of patients with different ECOG PS. (D) The median PFS of patients with different baseline EGFR mutation status. PD-L1, programmed death-ligand 1; PFS, progression-free survival; OS, overall survival; ECOG PS, Eastern Cooperative Oncology Group performance status; EGFR, epidermal growth factor receptor.
Figure 3
Figure 3
The clinical efficacy of osimertinib regarding different PD-L1 expression levels. (A) The median PFS in patients with PD-L1 < 50% and ≧50%. (B) The median OS in patients with PD-L1 < 50% and ≧50%. (C) The median PFS in patients with PD-L1 < 1%, 1 to 49% and ≧50%. (D) The median OS in patients with PD-L1 < 1%, 1 to 49% and ≧50%. PD-L1, programmed death-ligand 1; PFS, progression-free survival; OS, overall survival.
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References

    1. Shi Y, et al. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER) J. Thorac. Oncol. 2014;9(2):154–162. doi: 10.1097/JTO.0000000000000033. - DOI - PMC - PubMed
    1. Hsu KH, et al. Identification of five driver gene mutations in patients with treatment-naïve lung adenocarcinoma in Taiwan. PLoS ONE. 2015;10(3):e0120852. doi: 10.1371/journal.pone.0120852. - DOI - PMC - PubMed
    1. Lynch TJ, et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N. Engl. J. Med. 2004;350(21):2129–2139. doi: 10.1056/NEJMoa040938. - DOI - PubMed
    1. Paez JG, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004;304(5676):1497–1500. doi: 10.1126/science.1099314. - DOI - PubMed
    1. Rosell R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13(3):239–246. doi: 10.1016/S1470-2045(11)70393-X. - DOI - PubMed