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EGFR Mutations and PD-L1 Expression in Early-Stage Non-Small Cell Lung Cancer: A Real-World Data From a Single Center in Brazil

2022; AlphaMed Press; Volume: 27; Issue: 11 Linguagem: Inglês

10.1093/oncolo/oyac167

ISSN

1549-490X

Autores

Icaro Alves Pinto, Rodrigo de Oliveira Cavagna, Aline Larissa Virginio da Silva, Josiane Mourão Dias, Iara Vidigal Santana, Laísa Caroline Souza, Flávio Augusto Ferreira da Silva, Maria Fernanda Biazotto Fernandes, Gustavo Dix Junqueira Pinto, Izabella Santos Negreiros, Maria Fernanda Santiago Gonçalves, Flávia Escremim de Paula, Gustavo Nóriz Berardinelli, Giovanna Casagrande, Marcela Oliveira da Silva, Eduardo Caetano Albino da Silva, Marco Antônio de Oliveira, Alexandre Arthur Jacinto, Vinícius Duval da Silva, Rui Manuel Reis, Pedro De Marchi, Letícia Ferro Leal,

Tópico(s)

Lung Cancer Diagnosis and Treatment

Resumo

Abstract Background Targeted and immunotherapies are currently moving toward early-stage settings for patients with non-small cell lung cancer (NSCLC). Predictive biomarkers data are scarce in this scenario. We aimed to describe the frequency of EGFR mutations and PD-L1 expression levels in early-stage non-squamous patients with NSCLC from a large, single Brazilian oncology center. Methods We retrospectively evaluated patients with NSCLC diagnosed at an early-stage (IB to IIIA-AJCC seventh edition) at Barretos Cancer Hospital (n = 302). EGFR mutational status was assessed in FFPE tumor tissues using distinct methodologies (NGS, Cobas, or Sanger sequencing). PD-L1 expression was evaluated by immunohistochemistry (clone 22C3) and reported as Tumor Proportion Score (TPS), categorized as <1%, 1-49%, and ≥50%. We evaluated the association between EGFR mutational status and PD-L1 expression with sociodemographic and clinicopathological parameters by Fisher’s test, qui-square test, and logistic regression. Survival analysis was assessed by the Kaplan-Meier method and Cox regression model. Results EGFR mutations were detected in 17.3% (n = 48) of cases and were associated with female sex, never smokers, and longer overall and event-free survival. PD-L1 positivity was observed in 36.7% (n = 69) of cases [TPS 1-49% n = 44(23.4%); TPS ≥50% n = 25(13.3%)]. PD-L1 positivity was associated with smoking, weight loss, and higher disease stages (IIB/IIIA). Conclusion The frequencies of EGFR mutations and PD-L1 positivity were described for early-stage non-squamous patients with NSCLC. These results will be essential for guiding treatment strategies with the recent approvals of osimertinib and immunotherapy in the adjuvant setting.

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