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. 2024 Jul;15(20):1598-1606.
doi: 10.1111/1759-7714.15336. Epub 2024 Jun 11.

PD-L1 expression in patients with non-small-cell lung cancer is associated with sex and genetic alterations: A retrospective study within the Caucasian population

P Sarova  1 , B Mosleh  2 , S Zehetmayer  3 , F Oberndorfer  4 , J Widder  5 , H Prosch  6 , C Aigner  2 , M Idzko  1 , M A Hoda  2 , D Gompelmann  1
Affiliations

PD-L1 expression in patients with non-small-cell lung cancer is associated with sex and genetic alterations: A retrospective study within the Caucasian population

P Sarova et al. Thorac Cancer. 2024 Jul.

Abstract

Background: Programmed cell death-ligand 1 (PD-L1) expression is a well-established biomarker for predicting responses to immune checkpoint inhibitors and certain targeted therapies. As a result, treatment strategies for patients vary based on their PD-L1 expression status. Understanding the clinical features of patients with distinct PD-L1 levels is crucial for personalized treatment approaches.

Methods: Demographic and clinicopathological characteristics of 227 patients (54% male, mean age 67 ± 9.9 years) newly diagnosed with non-small-cell lung cancer (NSCLC) between April 2020 and December 2022 were retrospectively compared among three groups based on the PD-L1 expression: PD-L1 Tumor Proportion Score (TPS) negative, 1-50%, and ≥50%. Logistic regression analysis was performed to evaluate predictors for high PD-L1 expression ≥50%.

Results: PD-L1 expression levels were distributed as follows: negative in 29% of patients, between 1% and 50% in 41%, and greater than 50% (high) in 29%. In comparison to negative PD-L1 expression, low and high PD-L1 expression was associated with female sex (32.9% vs. 52.7% vs. 50.7%, p = 0.031), with the absence of epidermal growth factor receptor (EGFR) mutations (83.6% vs. 91.1% vs. 98.1% p = 0.029), and with the absence of ERBB2 (HER2) tyrosine kinase mutations (90.9% vs. 100% vs. 98.1% p = 0.007), respectively. Age, smoking status, histological subtype, and disease stage showed no significant differences among the three patient groups. In the univariate logistic regression, EGFR mutation appeared to be the only predictor for PD-L1 expression, although it did not reach statistical significance (p = 0.06).

Conclusion: Although sex and genomic alterations are associated with PD-L1 expression in patients with NSCLC, no clinical characteristics seem to predict PD-L1 expression significantly.

Keywords: PD‐L1 status; gender medicine; genetic aberrations; non‐small cell lung cancer.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article. Conflict interests outside the submitted article: B. Mosleh, P. Sarova, S. Zehetmayer, F. Oberndorfer, and M. Idzko: None. J. Widder: Consulting fee Astra Zeneca outside the present project. H. Prosch: Lecture fees from Boehringer Ingelheim, AstraZeneca, MSD, BMS, Janssen, Roche. C. Aigner: BMS, PharmaCept, MSD, AstraZeneca, Roche, Biotest. A. Hoda: Lecture fees from AstraZeneca, MSD, BMS, Advisory boards with MSD, BMS, AstraZeneca. D. Gompelmann: Lecture fees from AstraZeneca, MSD, Erbe, Olympus, Chiesi, Berlin Chemie, Böhringer Ingelheim, Pulmonx outside the present project.

Figures

FIGURE 1
FIGURE 1
Pairwise comparisons of the proportions of male sex, epidermal growth factor receptor EGFR mutations, and ERBB2 mutations (erb‐b2 receptor tyrosine kinase 2) within each programmed death‐ligand 1 (PD‐L1) expression group among the three PD‐L1 categories based on cut‐off values: <1% (negative), 1–49% (low), and >50% (high). The PD‐L1 negative group showed a significantly higher prevalence of male sex, as well as the presence of EGFR and ERBB2 mutations.
FIGURE 2
FIGURE 2
Survival time among the three programmed death‐ligand 1 expression groups.
See this image and copyright information in PMC

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