Πέμπτη 1 Σεπτεμβρίου 2016

The up-regulation of PD-L1 promotes the resistant response in non-small cell lung cancer patients with neo-adjuvant chemotherapy

Abstract

To assess the significance of programmed cell death ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) and its association with cisplatin-based neo-adjuvant chemotherapy (NAC) response. We investigated that PD-L1 was increased in chemo-resistant tumors compared with chemo-sensitive tumors according to RNA-Seq analysis, which was confirmed in the same cohort using IHC. In a cohort of 92 patients with NAC, the positive staining of PD-L1 was correlated with the TNM stage, lower sensitive-response rates and shorter overall survival rates. In another 30 paired tumor specimens pre- and post-chemotherapy, the patients with high PD-L1 expression of post-chemotherapy had a worse outcome and higher stable disease rate. CD8+ tumor infiltrating lymphocytes (TILs) was found to be related to chemosensitive response and better prognosis and negative PD-L1 expression. Furthermore, in two PDX models and cell lines A549 and PC-9, cisplatin up-regulated PD-L1 expression, and the enhancement of PD-L1 in cancer cell lines was in a drug dose dependent manner. Moreover, the depletion of PD-L1 significantly reduced the cisplatin resistance. When PI3K/AKT signaling was inhibited by corresponding inhibitors, PD-L1 expression was down-regulated and apoptosis was up-regulated in the cisplatin treated cancer cells. These results suggest that the up-regulation of PD-L1 promotes the resistant response in lung cancer cells that might be through activation of PI3K/AKT pathway and suppression of TILs. The high expression of PD-L1 after NAC could be the indication of therapeutic resistance and poor prognosis of NSCLC patients.

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