Significance of programmed cell death-ligand 1 expression and its association with survival in patients with small cell lung cancer

J Thorac Oncol. 2015 Mar;10(3):426-30. doi: 10.1097/JTO.0000000000000414.


Background: Programmed cell death 1 receptor-ligand interaction is a major pathway often hijacked by tumors to suppress immune control. The aim of this retrospective study was to investigate the prevalence and prognostic roles of programmed cell death -ligand 1 (PD-L1) expression in small cell lung cancer (SCLC).

Methods: The expression of PD-L1 was evaluated by immunohistochemical analysis in 102 specimens of SCLC. Tumors with staining in over 5% of tumor cells were scored as positive for PD-L1 expression. Survival analysis was performed using the Kaplan-Meier method.

Results: Expression of PD-L1 in tumor cells was observed in 71.6% (73 of 102) of SCLCs, and was significantly correlated with a limited disease (LD) stage. SCLC patients with PD-L1-positive tumors showed significantly longer overall survival (OS) than those with PD-L1-negative (median OS, 16.3 versus 7.3 months; p < 0.001, respectively). Multivariate analyses demonstrated that a good performance status, LD stage, and expression of PD-L1 were significantly predictive of better OS, independently of other factors. We found no relevance between PD-L1 expression and progression-free survival for first-line treatment in LD- and extensive disease-SCLC patients.

Conclusions: In patients with SCLC, expression of PD-L1 is positively correlated with a LD stage, and is independently predictive of a favorable outcome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • B7-H1 Antigen / metabolism*
  • Biomarkers, Tumor / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Small Cell Lung Carcinoma / metabolism
  • Small Cell Lung Carcinoma / mortality
  • Small Cell Lung Carcinoma / secondary*
  • Survival Rate


  • B7-H1 Antigen
  • Biomarkers, Tumor
  • CD274 protein, human