Positive PD‑L1 expression is predictive for patients with advanced EGFR wild‑type non‑small cell lung cancer treated with gemcitabine and cisplatin

Qiu,Yajuan; Jiang,Junguang; Zhang,Mingzhi; Qin,Yanru

doi:10.3892/ol.2019.10302

Positive PD‑L1 expression is predictive for patients with advanced EGFR wild‑type non‑small cell lung cancer treated with gemcitabine and cisplatin

Authors:
- Yajuan Qiu
- Junguang Jiang
- Mingzhi Zhang
- Yanru Qin
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Affiliations: Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China, Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
Published online on: May 2, 2019 https://doi.org/10.3892/ol.2019.10302
Pages: 161-168
Copyright: © Qiu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This retrospective study aimed to investigate the association between programmed death ligand‑1 (PD‑L1) expression and the clinicopathological characteristics of patients with advanced epidermal growth factor receptor (EGFR) wild‑type non‑small cell lung cancer (NSCLC). The predictive role and cut‑off value of PD‑L1 expression was subsequently investigated. A total of 172 patients with advanced EGFR wild‑type NSCLC were enrolled. All patients received platinum‑based doublet chemotherapy (gemcitabine plus cisplatin). PD‑L1 expression in lung tissues was assessed using immunohistochemical methods. The χ2 test was used to analyze the association between PD‑L1 expression and clinicopathological characteristics. Survival time analysis was performed using the Kaplan‑Meier method. The two groups, positive PD‑L1 expression and negative PD‑L1 expression, were compared using the log‑rank test. Multivariate analysis using the Cox proportional hazard regression model was conducted to determine prognostic factors for overall survival (OS) and progression‑free survival (PFS) times. Positive PD‑L1 expression was observed in 48.3% (84/172), 40.7% (70/172), 21.5% (37/172) and 8.1% (14/172) of patients when using cut‑off values of 1, 5, 10 and 50%, respectively. The χ2 test revealed that elevated pretreatment C‑reactive protein (CRP) level and cancer stage IV were significantly associated with positive PD‑L1 expression. The OS and PFS of positive PD‑L1 (1, 5, 10 and 50% cut‑off) expression group were shorter compared with the negative PD‑L1 (1, 5, 10 and 50% cut‑off) expression group. Multivariate survival analysis revealed that PD‑L1 expression ≥50% was significantly associated with decreased OS and PFS [OS time, P=0.001; hazard ratio (HR), 2.768; 95% confidence interval (CI), 1.551‑4.940; PFS time, P=0.002; HR, 2.537; 95% CI, 1.423‑4.524]. These results indicated that positive PD‑L1 (50% cut‑off) expression was an independent predictor of poor prognosis for patients with advanced NSCLC treated with gemcitabine plus cisplatin. PD‑L1 expression was associated with CRP level and cancer stage. The results obtained in the present study suggest that positive PD‑L1 expression serves a prognostic role in advanced NSCLC and that the optimal cut‑off value may be 50%.

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