Liam, Chong Kin and Yew, Chian Yih and Pang, Yong Kek and Wong, Chee Kuan and Poh, Mau Ern and Tan, Jiunn Liang and Soo, Chun Ian and Loh, Thian Chee and Chin, Ka Kiat and Munusamy, Vijayan and Liam, Yong Sheng and Ibrahim, Nur Husna (2023) Common driver mutations and programmed death-ligand 1 expression in advanced non-small cell lung cancer in smokers and never smokers. BMC Cancer, 23 (1). ISSN 1471-2407, DOI https://doi.org/10.1186/s12885-023-11156-y.
Full text not available from this repository.Abstract
BackgroundIn non-small cell lung cancer (NSCLC), there may be a relationship between programmed death-ligand 1 (PD-L1) expression, driver mutations and cigarette smoking.MethodsIn this single-center retrospective study, the relationship between common driver mutations (EGFR mutation and ALK rearrangement) and PD-L1 expression in advanced NSCLC according to the patients' smoking history was examined. Light, moderate and heavy smokers had smoked < 20, 20-39, and & GE; 40 pack-years, respectively. The level of PD-L1 expression, assessed using Ventana SP263 monoclonal antibody assay, was defined by the tumor proportion score (TPS) as high expression (TPS & GE; 50%), low expression (TPS 1%-49%) and no expression (TPS < 1%).Results101 (52.9%) of 191 advanced NSCLC patients were never smokers. EGFR mutations were more common in never smokers (64.4%) than in smokers (17.8%) with advanced NSCLC (P < 0.0001). A higher proportion of smokers (26.7%) had high PD-L1 expression compared to never smokers (13.9%) (P = 0.042). There was a trend for a higher proportion of male NSCLC patients 28 of 115 (24.3%)] than female patients 10 of 76 (13.2%)] to have high PD-L1 expression (P = 0.087]. High PD-L1 expression was seen in 32 of 110 (29.1%) patients with EGFR wild-type NSCLC but only in 6 of 81 (7.4%) patients with EGFR-mutant tumors (P < 0.0001). Among the 90 smokers with NSCLC, a higher proportion of heavy smokers (35.8%) than non-heavy smokers (13.5%) had high PD-L1 expression (P = 0.034). In patients with adenocarcinoma, high PD-L1 expression was seen in 25 of 77 (32.5%) patients with EGFR wild-type tumors but only in 4 of 70 (5.7%) patients with EGFR-mutant tumors (P < 0.0001). Among patients with adenocarcinoma, a significantly higher proportion of ever smokers (29.3%) than never smokers (13.5%) had high PD-L1 expression (P = 0.032). Among smokers with adenocarcinoma, a significantly higher proportion of heavy smokers (44.1%) than non-heavy smokers (8.3%) had high PD-L1 expression (P = 0.004). On multivariate analysis, after adjusting for gender and smoking status, heavy smoking and EGFR wild-type tumors remained significantly associated with high PD-L1 expression in NSCLCs and also in adenocarcinoma.ConclusionsHeavy smoking and EGFR wild-type tumors were significantly associated with high PD-L1 expression in NSCLCs and also in adenocarcinoma. Key messagesSignificant findings of the studyIn advanced NSCLC, particularly in advanced adenocarcinoma, high PD-L1 expression is significantly more common in smokers than in never smokers, in EGFR wild-type than EGFR-mutant tumors in both males and females and in heavy smokers among smokers. On multivariate analysis, NSCLCs including adenocarcinoma in patients who are heavy smokers and which are EGFR wild-type are significantly associated with high PD-L1 expression.What this study addsIn a region where a high proportion of NSCLC patients are never smokers and EGFR mutation is highly prevalent, high PD-L1 expression in NSCLC and adenocarcinoma in particular is significantly associated with heavy smoking and EGFR wild-type tumors.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | EGFR mutations; NSCLC; PD-L1; Smoking status |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Medicine Department Universiti Malaya Medical Centre (UMMC) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Oct 2025 06:43 |
| Last Modified: | 30 Oct 2025 06:43 |
| URI: | http://eprints.um.edu.my/id/eprint/48695 |
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