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Region Hovedstaden - en del af Københavns Universitetshospital
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Programmed cell death ligand-1 expression and survival in a cohort of patients with non-small cell lung cancer receiving first-line through third-line therapy in Denmark

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  • Elizabeth Hedgeman
  • Mette Nørgaard
  • Tapashi Dalvi
  • Lars Pedersen
  • Hanh Pham Hansen
  • Jill Walker
  • Anita Midha
  • Norah Shire
  • Anne Marie Boothman
  • Jon P. Fryzek
  • James Rigas
  • Anders Mellemgaard
  • Torben R. Rasmussen
  • Stephen Hamilton-Dutoit
  • Deirdre Cronin-Fenton
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Background: PD-L1 expression on tumor cells (TCs) or immune cells (ICs) may be used as a prognostic marker for survival in patients with NSCLC. We characterized PD-L1 expression on TCs or ICs in a patient cohort with NSCLC to determine associations between PD-L1 expression and overall survival (OS), according to EGFR and KRAS mutation status. Methods: Danish patients aged >18 years diagnosed with NSCLC before 2014 on first- (N = 491), second- (N = 368), or third-line (N = 498) therapy were included. Data were extracted from population-based medical registries. Tumor samples from pathology archives were tested for biomarkers. High PD-L1 expression was defined as expression on ≥25 % of TCs or ICs based on first diagnostic biopsy or surgical resection. KRAS and EGFR mutation status were tested using PCR-based assays. Cox regression analysis was used to compute adjusted HRs and associated 95 % CIs. Results: PD-L1 TC and IC ≥ 25 % were observed in 24.3 %–31.0 % and 11.7–14.7 % of patients, respectively. EGFR and KRAS mutations were detected in 4.7 %–8.8 % and 26.5 %–30.7 % of patients, respectively. PD-L1 TC ≥ 25 % was not associated with survival advantage in first- (HR = 0.96, 95 % CI: 0.75–1.22), second- (1.08, 0.81–1.42), or third-line (0.94, 0.74–1.20) therapy. PD-L1 IC ≥ 25 % was associated with survival advantage in second-line (HR = 0.56, 95 % CI: 0.36–0.86) and third-line (0.69, 0.49–0.97) but not first-line (1.00, 0.70–1.41) therapy. Conclusion: No association was observed between PD-L1 TC ≥ 25 % and OS in any therapy line. PD-L1 IC ≥ 25 % may confer survival benefit among some patients who reach second-line therapy.

OriginalsprogEngelsk
Artikelnummer101976
TidsskriftCancer epidemiology
Vol/bind73
Sider (fra-til)101976
ISSN1877-7821
DOI
StatusUdgivet - aug. 2021

Bibliografisk note

Funding Information:
This work was funded by AstraZeneca research grants to EpidStat Institute to manage and administer the work. Aarhus University, Denmark, received funds from EpidStat Institute to conduct the work. The sponsor contributed to the design and implementation of the study. The authors had final responsibility for the decision to submit the manuscript for publication.

Funding Information:
Elizabeth Hedgeman reports personal fees from Astra Zeneca during the conduct of the study. Mette Nørgaard reports the work was funded by AstraZeneca as a research grant to (and administered by) Aarhus University, Denmark. Tapashi Dalvi , Jill Walker, Anita Midha, Norah Shire , Anne-Marie Boothman, and James Rigas are employees of AstraZeneca and report personal fees from AstraZeneca during the conduct of the study and outside the submitted work. Lars Pedersen reports the work was funded by AstraZeneca as a research grant to (and administered by) Aarhus University, Denmark. Jon P. Fryzek reports grants from EpidStrategies during the conduct of the study. Deirdre Cronin-Fenton reports the work was funded by AstraZeneca as a research grant to (and administered by) Aarhus University, Denmark. Hanh Pham Hansen , Anders Mellemgaard , Torben R. Rasmussen , and Stephen Hamilton-Dutoit have nothing to disclose.

Publisher Copyright:
© 2021

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