The aim of our analysis was to evaluate the prognostic effect of programmed cell death ligand-1 (PD-L1) expression in patients with non-small-cell lung cancer (NSCLC).
PD-L1 expression among 1070 surgically resected NSCLC specimens was evaluated by immunohistochemistry. Data were analyzed using Cox proportional hazard models, adjusting for age, sex, smoking status, histology, stage, and performance status.
Sixty-eight patients (6%) were PD-L1 strong positive; 410 (38%) were PD-L1 weak positive. A significantly higher prevalence of PD-L1 positivity was observed among patients with squamous cell carcinoma and among stage IIIB/IV patients. PD-L1 expression may be associated with poorer overall survival, with an adjusted hazard ratio (HR) of 1.56 (95% confidence interval [CI], 1.08-2.26; p=0.02) for PD-L1 strong positive, 1.18 (95% CI, 0.96-1.46; p=0.12) for PD-L1 weak positive, and 1.23 (95% CI, 1.00-1.51; p=0.05) for the combined strong- and weak-positive groups compared with PD-L1 negative. Negative prognostic effect of PD-L1 expression was not statistically significant after adjusting for postsurgical chemotherapy or radiotherapy. Similar results were observed for progression-free survival. Among stage I patients, the disease recurrence rate was higher in the PD-L1-positive versus negative group (48% versus 27%, p<0.001), with an adjusted HR for disease-free survival of 2.01 (95% CI, 1.08-3.73; p=0.03) for PD-L1 strong positive and 1.57 (95% CI, 1.17-2.11; p=0.003) for PD-L1 weak positive compared with PD-L1 negative.
Tumor PD-L1 expression may be associated with poor prognosis in patients with NSCLC, although its significance weakens when postsurgical therapy is considered.
Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

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