1. Impact of tumor microenvironment on the efficacy of epidermal growth factor receptor‐tyrosine kinase inhibitors in patients with<scp>EGFR</scp>‐mutant non‐small cell lung cancer
- Author
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Jun Oyanagi, Tetsuya Watanabe, Koichi Ogawa, Mitsuru Fukui, Hiroyasu Kaneda, Tomoya Kawaguchi, Yasuhiro Koh, Yoshiya Matsumoto, Tomohiro Suzumura, Tatsuo Kimura, Shigeki Mitsuoka, Kenji Sawa, Nobuyuki Yamamoto, Motohiro Izumi, and Kazuhisa Asai
- Subjects
Male ,0301 basic medicine ,epidermal growth factor receptor tyrosine kinase inhibitor ,Cancer Research ,Lung Neoplasms ,Cell ,Gastroenterology ,B7-H1 Antigen ,0302 clinical medicine ,Japan ,Carcinoma, Non-Small-Cell Lung ,Tumor Microenvironment ,Medicine ,Epidermal growth factor receptor ,Aged, 80 and over ,education.field_of_study ,biology ,Kinase ,General Medicine ,Middle Aged ,ErbB Receptors ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Immunohistochemistry ,Original Article ,Female ,Programmed cell death 1 ligand 2 ,non‐small cell lung cancer ,Adult ,medicine.medical_specialty ,CD8 Antigens ,03 medical and health sciences ,Lymphocytes, Tumor-Infiltrating ,Clinical Research ,Internal medicine ,Humans ,Lung cancer ,education ,Protein Kinase Inhibitors ,Aged ,Retrospective Studies ,Tumor microenvironment ,business.industry ,Original Articles ,programmed cell death‐1 ligand‐1 ,Programmed Cell Death 1 Ligand 2 Protein ,medicine.disease ,programmed cell death‐1 ligand‐2 ,Survival Analysis ,030104 developmental biology ,Mutation ,biology.protein ,business ,CD8 - Abstract
We retrospectively investigated the impact of the tumor microenvironment (TME) on the efficacy of epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors (TKIs) as first‐line treatment in 70 patients with advanced EGFR‐mutant non‐small cell lung cancer and who were seen at Osaka City University Hospital (Osaka, Japan) between August 2013 and December 2017. Using immunohistochemical staining with 28‐8 and D7U8C Abs, the tumor proportion score was assessed for programmed cell death‐1 ligand‐1 (PD‐L1), as high (50% or more) or low (less than 50%), and ligand‐2 (PD‐L2) expression, respectively. The extent of CD8+ tumor‐infiltrating lymphocytes was evaluated on a scale of 0‐3, with 0‐1 as low and 2‐3 as high. The TME of the 52 evaluable pretreatment specimens was categorized into 4 subtypes, according to the respective PD‐L1 tumor proportion and CD8+ scores, as follows: (a) high/high (13.5%, n = 7); (b) low/low (42.3%, n = 22); (c) high/low (17.3%, n = 9); and (d) low/high (26.9%, n = 14). Expression of PD‐L2 was significantly the highest in type 1 (57.1% vs 4.5% vs 11.1% vs 7.1%, respectively; P = .0090). Response rate was significantly the lowest in type 1 (14.3% vs 81.8% vs 66.7% vs 78.6%, respectively; P = .0085). Progression‐free survival was the shortest in type 1 and the longest in type 4 (median, 2.4 vs 11.3 vs 8.4 vs 17.5 months, respectively; P = .00000077). The efficacy of EGFR‐TKIs differed according to the TME, and the phenotype with high PD‐L1 and CD8+ expression might be the subset that would poorly benefit from such treatment.
- Published
- 2019