Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India
Immune checkpoint inhibitor (PD-L1) therapy of advanced non-small-cell lung cancer (NSCLC) has variable outcomes. Tumor subtypes based on PD-L1 expression, histopathology, mutation burden is required for patient stratification and formulation of treatment guidelines. Lung cancers (n=57) diagnosed a...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-02-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/index.php/macd/article/view/2449 |
| _version_ | 1797934990251524096 |
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| author | Ritu Kulshrestha Himanshi Saxena Raj Kumar Sonam Spalgius Parul Mrigpuri Nitin Goel Balakrishnan Menon Meenu Rani Pawan Mahor Ishita Bhutani |
| author_facet | Ritu Kulshrestha Himanshi Saxena Raj Kumar Sonam Spalgius Parul Mrigpuri Nitin Goel Balakrishnan Menon Meenu Rani Pawan Mahor Ishita Bhutani |
| author_sort | Ritu Kulshrestha |
| collection | DOAJ |
| description |
Immune checkpoint inhibitor (PD-L1) therapy of advanced non-small-cell lung cancer (NSCLC) has variable outcomes. Tumor subtypes based on PD-L1 expression, histopathology, mutation burden is required for patient stratification and formulation of treatment guidelines. Lung cancers (n=57) diagnosed at Pathology department, VPCI (2018-2021) were retrospectively analyzed. PD-L1(SP263) expressed by tumor cells [low (<1%), medium (1-49%), high (≥50%)] was correlated with histopathology, microenvironment, EGFR, KRAS expression. Patients were categorized into high and low risk based on their: i) gender: males (n=47, 30-89 years), females (n=10, 45-80 years); ii) smoking history: males 26/47 (45.61%), females 1/10 (10%); iii) tumor subtyping: squamous cell carcinoma 15/57 (26.32%), adenocarcinoma 6/57 (17.54%), NSCLC-undifferentiated 24/57 (42.10%), adenosquamous carcinoma 5/57 (8.77 %), carcinosarcoma 4/57 (7.02%), small cell carcinoma 1/57 (1.75%); iv) inflammatory tumor microenvironment/TILs 44/57 (77.1%); iv) PD-L1 positivity-31/57 (54.3%); v) concomitant EGFR/KRAS positivity. PD-L1positive cases showed squamous/undifferentiated histopathology, concomitant EGFR+ (9/20, 45%) and KRAS+ (8/15, 53.3%), smoking+ (21/31,67.74%).PD-L1 negative cases (26/57, 45.6%), were EGFR+ (2/14, 14.28%) and KRAS+ (6/19, 31.5%). The high-risk lung cancer subtypes show squamous/undifferentiated histopathology, inflammatory microenvironment, male preponderance, smoking history, higher concomitant PD-L1, KRAS and EGFR positivity. Lung cancer subtyping can predict clinical response/resistance of patients prior to initiation of PD-L1 inhibitor therapies and can be used to guide therapy.
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| first_indexed | 2024-04-10T18:07:34Z |
| format | Article |
| id | doaj.art-cf0cc1aa438a4706acceba32ace7d257 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-04-10T18:07:34Z |
| publishDate | 2023-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-cf0cc1aa438a4706acceba32ace7d2572023-02-02T12:29:18ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642023-02-0110.4081/monaldi.2023.2449Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North IndiaRitu Kulshrestha0Himanshi Saxena1Raj Kumar2Sonam Spalgius3Parul Mrigpuri4Nitin Goel5Balakrishnan Menon6Meenu Rani7Pawan Mahor8Ishita Bhutani9Department of Pathology, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pathology, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pathology, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pathology, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pathology, Vallabhbhai Patel Chest Institute, University of Delhi Immune checkpoint inhibitor (PD-L1) therapy of advanced non-small-cell lung cancer (NSCLC) has variable outcomes. Tumor subtypes based on PD-L1 expression, histopathology, mutation burden is required for patient stratification and formulation of treatment guidelines. Lung cancers (n=57) diagnosed at Pathology department, VPCI (2018-2021) were retrospectively analyzed. PD-L1(SP263) expressed by tumor cells [low (<1%), medium (1-49%), high (≥50%)] was correlated with histopathology, microenvironment, EGFR, KRAS expression. Patients were categorized into high and low risk based on their: i) gender: males (n=47, 30-89 years), females (n=10, 45-80 years); ii) smoking history: males 26/47 (45.61%), females 1/10 (10%); iii) tumor subtyping: squamous cell carcinoma 15/57 (26.32%), adenocarcinoma 6/57 (17.54%), NSCLC-undifferentiated 24/57 (42.10%), adenosquamous carcinoma 5/57 (8.77 %), carcinosarcoma 4/57 (7.02%), small cell carcinoma 1/57 (1.75%); iv) inflammatory tumor microenvironment/TILs 44/57 (77.1%); iv) PD-L1 positivity-31/57 (54.3%); v) concomitant EGFR/KRAS positivity. PD-L1positive cases showed squamous/undifferentiated histopathology, concomitant EGFR+ (9/20, 45%) and KRAS+ (8/15, 53.3%), smoking+ (21/31,67.74%).PD-L1 negative cases (26/57, 45.6%), were EGFR+ (2/14, 14.28%) and KRAS+ (6/19, 31.5%). The high-risk lung cancer subtypes show squamous/undifferentiated histopathology, inflammatory microenvironment, male preponderance, smoking history, higher concomitant PD-L1, KRAS and EGFR positivity. Lung cancer subtyping can predict clinical response/resistance of patients prior to initiation of PD-L1 inhibitor therapies and can be used to guide therapy. https://www.monaldi-archives.org/index.php/macd/article/view/2449Subtyping-lung cancer, PD-L1, coexisting EGFR/KRAS mutations, tumour histopathology, North India |
| spellingShingle | Ritu Kulshrestha Himanshi Saxena Raj Kumar Sonam Spalgius Parul Mrigpuri Nitin Goel Balakrishnan Menon Meenu Rani Pawan Mahor Ishita Bhutani Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India Monaldi Archives for Chest Disease Subtyping-lung cancer, PD-L1, coexisting EGFR/KRAS mutations, tumour histopathology, North India |
| title | Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India |
| title_full | Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India |
| title_fullStr | Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India |
| title_full_unstemmed | Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India |
| title_short | Subtyping of advanced lung cancer based on PD-L1 expression, tumor histopathology and mutation burden (EGFR and KRAS): a study from North India |
| title_sort | subtyping of advanced lung cancer based on pd l1 expression tumor histopathology and mutation burden egfr and kras a study from north india |
| topic | Subtyping-lung cancer, PD-L1, coexisting EGFR/KRAS mutations, tumour histopathology, North India |
| url | https://www.monaldi-archives.org/index.php/macd/article/view/2449 |
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