PD-L1-expression patterns in large-cell neuroendocrine carcinoma of the lung: potential implications for use of immunotherapy in these patients: the GFPC 03-2017 "EPNEC" study. (July 2020)

• Record Type: Journal Article
• Authors: Arpin, Dominique; Charpentier, Marie-Christine; Bernardi, Marie; Monnet, Isabelle; Boni, Aurelie; Watkin, Emmanuel; Goubin-Versini, Isabelle; Lamy, Régine; Gérinière, Laurence; Geier, Margaux; Forest, Fabien; Gervais, Radj; Madrosyk, Anne; Guisier, Florian; Serrand, Cécile; Locher, Chrystèle; Decroisette, Chantal; Fournel, Pierre; Auliac, Jean-Bernard; Jeanfaivre, Thierry; Letreut, Jacques; Doubre, Hélène; Francois, Geraldine; Piton, Nicolas; Chouaïd, Christos; Damotte, Diane
• Is Part Of: Therapeutic advances in medical oncology. Volume 12(2020)
• Publication Date: 2020-07
• Subjects: immunotherapy -- inflammatory cells -- neuroendocrine carcinoma of the lung -- PD-L1 -- prognosis; Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.994005
• DOI: 10.1177/1758835920937972
• Languages: English
• ISSNs: 1758-8340

Abstract

Background: Few data are available on programmed cell-death-protein-1–ligand-1 (PD-L1) expression on large-cell neuroendocrine carcinomas of the lung (LCNECs). We analyzed PD-L1 expression on tumor (TCs) and inflammatory cells (ICs) from LCNEC patients to assess relationships between this expression, clinical characteristics, and disease outcomes. Methods: PD-L1 expression was determined by immunohistochemistry with monoclonal antibody 22C3 in consecutive LCNEC patients managed in 17 French centers between January 2014 and December 2016. Results: After centralized review, only 68 out of 105 (64%) patients had confirmed LCNEC diagnoses. Median overall survival (OS) (95% CI) was 11 (7–16) months for all patients, 7 (5–10), 21 (10–not reached) and not reached months for metastatic, stage III and localized forms ( p = 0.0001). Respectively, 11% and 75% of the tumor samples were TC+ and IC+, and 66% had a TC–/IC+ profile. Comparing IC+ versus IC– metastatic LCNEC, the former had significantly longer progression-free survival [9 (4–13) versus 4 (1–8) months; p = 0.03], with a trend towards better median OS [12 (7–18) versus 9.5 (4–14) months; p = 0.21]. Compared to patients with TC– tumors, those with TC+ LCNECs tended to have non-significantly shorter median OS [4 (1–6.2) versus 11 (8–18) months, respectively]. Median OS was significantly shorter for patients with TC+/IC– metastatic LCNECs than those with TC–IC+ lesions (2 versus 8 months, respectively; p = 0.04). Conclusion: TC–/IC+ was the most frequent PD-L1–expression profile for LCNECs, a pattern quite specific compared with non-small-cell lung cancer and small-cell lung cancer. IC PD-L1 expression seems to have a prognostic role.