The correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma patients: a single center case series
Abstract
Objective:
To explore the relationship and overlap between PD-L1 expression and common genomic alterations in Chinese patients with lung adenocarcinoma (LADC).
Methods:
A total of 428 consecutive LADC cases that underwent surgical resection between October 2015 and December 2016 were retrospectively analyzed. PD-L1 expression was assessed using the tumor proportion score (TPS). Associations between PD-L1 expression levels and classical driver mutations—including EGFR, ALK, ROS1, and KRAS—as well as clinical characteristics and disease-free survival (DFS), were examined.
Results:
PD-L1 expression (TPS ≥ 1%) was observed in 70 cases (16.4%), with high expression (TPS ≥ 50%) in 21 cases (4.9%). PD-L1 positivity was significantly associated with male gender, smoking history, advanced TNM stage, and solid histologic subtype. Both PD-L1 expression thresholds (TPS ≥ 1% and TPS ≥ 50%) were inversely correlated with EGFR mutations (P < 0.001) and positively associated with ALK rearrangements (P = 0.024). KRAS mutations were significantly linked to high PD-L1 expression (TPS ≥ 50%) (P = 0.035). PD-L1 expression frequently co-occurred with classical driver gene alterations—58.5% of cases with TPS ≥ 1% and 42.9% with TPS ≥ 50%. In patients with stage III/IV disease or cancer progression, nearly 75% of PD-L1 positive tumors also harbored actionable driver mutations. Based on biomarker profiles, LADC cases could be stratified into four subgroups to inform targeted therapeutic approaches.
Conclusions:
PD-L1 expression in Chinese LADC patients shows a strong association and NVL-655 considerable overlap with classical oncogenic driver mutations. These insights support the integration of PD-L1 and driver gene profiling to guide personalized treatment strategies.