BMC Cancer (Sep 2022)

Programmed cell death ligand 1 measurement study in granulocyte colony-stimulating factor-producing lung cancer: an observational study

  • Kazuhito Miyazaki,
  • Aya Shiba,
  • Toshiki Ikeda,
  • Yuko Higashi,
  • Masaharu Aga,
  • Yusuke Hamakawa,
  • Yuri Taniguchi,
  • Yuki Misumi,
  • Yoko Agemi,
  • Yukiko Nakamura,
  • Tsuneo Shimokawa,
  • Hiroaki Okamoto

DOI
https://doi.org/10.1186/s12885-022-10065-w
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 6

Abstract

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Abstract Background Granulocyte colony-stimulating factor (G-CSF)-producing lung cancer induces severe inflammation and a high white blood cell (WBC) count and is associated with poor prognosis. A recent case of G-CSF-producing lung adenocarcinoma showed high expression of programmed cell death ligand 1 (PD-L1) and was treated with pembrolizumab as first-line therapy, which was extremely effective. We hypothesized that G-CSF-producing lung cancers are associated with high PD-L1 expression. Methods This retrospective study included patients diagnosed with lung cancer at Yokohama Municipal Citizen’s Hospital (Kanagawa, Japan) between 2009 and 2019. The PD-L1 status of 13 patients with high plasma G-CSF levels (≥40 pg/mL) was assessed by conducting immunohistochemical analysis of tissue samples. Results Of the total patients, 11 were men and 2 were women, with a median age of 74 years (70–85 years). Four, five, and three patients had adenocarcinoma, squamous cell carcinoma, and others, respectively. The median G-CSF level and WBC count were 85.5 pg/mL (range, 40.8–484 pg/mL) and 15,550/μL (range, 6,190–56,800/μL), respectively. The PD-L1 tumor proportion scores (TPSs) were ≥50%, 1%–49%, and <1% in 9, 1, and 3 patients, respectively. The median overall survival time was 7.3 months. Pembrolizumab was administered in six patients as first-line treatment, with two patients showing partial response, one patient with stable disease, and three patients with progressive disease. All six patients had a PD-L1 TPS of ≥50%. Conclusion G-CSF-producing lung cancers may be associated with increased PD-L1 expression. Although immune checkpoint inhibitors are an important treatment option for G-CSF-producing tumors, their effects are limited.

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