Punctate Anetoderma After Colony-Stimulating Factor 1 Receptor and Programmed Cell Death 1 Blockade With Irradiation: Clinicopathologic Characterization of a Novel Eruption.
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ABSTRACT:
SUBMITTER: Dai J
PROVIDER: S-EPMC8246336 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
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Punctate Anetoderma After Colony-Stimulating Factor 1 Receptor and Programmed Cell Death 1 Blockade With Irradiation: Clinicopathologic Characterization of a Novel Eruption.
Dai Julia J Zha Yuanyuan Y Foster Corey C CC Luke Jason J JJ Chmura Steven J SJ Hoffman Mark D MD
JAMA dermatology 20210801 8
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Project description:BackgroundGranulocyte 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.MethodsThis 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.ResultsOf 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%.ConclusionG-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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