Effect on Non-Small Cell Lung Cancer after Combination of Driver Gene Mutations and Anti-PD-1/PD-L1 Immunotherapy as Well as Chemotherapy

• Published in: Iranian journal of public health Vol. 53; no. 8; pp. 1754 - 1768
• Main Authors: Huang, Zhengming, Yu, Long, Chen, Weisong, Zhu, Dan, Chen, Hui
• Format: Journal Article
• Language: English
• Published: Iran Tehran University of Medical Sciences 01.08.2024
• Subjects: Original; Gene mutations; Prognostic analysis; Immunotherapy; Non-small cell lung cancer (NSCLC)
• ISSN: 2251-6085; 2251-6093; 2251-6093
• DOI: 10.18502/ijph.v53i8.16280

We aimed to reveal the correlation between pathological indicators and PD-L1, between gene mutation status in lung cancer through clinico-pathological data and lung cancer-related gene mutation and PD-L1 expression analysis. The study was conducted in Jinhua Municipal Central Hospital, Zhejiang, China from 2017 to 2022. PD-L1 testing and targeted gene mutations detection were evaluated. The clinical characteristics of these non-small cell lung cancer (NSCLC) samples have been obtained. The groups (LUAD, n=142; LUSC, n=143) were grouped according to clinico-pathological features and PD-L1 expression (Yes/No or High/Low), and the clinico-pathological and genetic and molecular features and correlation with PD-L1 expression were compared across the above groups. Comparisons and analyses were made between different treatment schemes. Lung adenocarcinoma (LUAD, n=142) and lung squamous carcinoma (LUSC, n=143) samples were enrolled (median age: 64 years old). Pleural invasion and M staging were significantly different from PD-L1 alterations ( <0.05). The percentage of patients with PD-L1 tumor proportion score (TPS)≥50% was 36.24% and the percentage of patients with PD-L1 TPS<50% was 29.53%. The percentage of patients with PD-L1 high-expressed and treated by immunotherapy was 75.93% and 63.41% experienced Partial Response/Complete Response. The mutations ratio of , , , , and were 28.86%, 1.34%, 6.04%, 0.67%, 1.34% and 0.67%, respectively. mutation was significantly different from PD-L1 alterations ( <0.01). There are individual differences in PD-L1 expression, which can also vary depending on the different clinical features. Specific molecular features correlate with differential PD-L1 expression and may influence the response to therapy.