PDL-1 Expression and Survival in Metastatic Non-small Cell Lung Cancer Patients Who Received Chemotherapy as First-Line Treatment

OBJECTIVE: To show the effect of programmed cell death protein-1 ligand level survival times in patients with metastatic non-small cell lung cancer receiving chemotherapy, to determine the relationship between programmed cell death protein-1 ligand level, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. MATERIAL AND METHODS: The data of 158 patients who received chemotherapy for metastatic non-small cell lung cancer were evaluated retrospectively. Clinical and demographic data, programmed cell death protein-1 ligand expression levels, and follow-up periods of the patients were recorded. The patients were divided into 2 groups according to programmed cell death protein-1 ligand levels. RESULTS: In all patients, progression-free survival was 5.6 months and overall survival was 18.8 months. Patients with low programmed cell death protein-1 ligand had a longer progression-free survival than patients with high programmed cell death protein-1 ligand (P = .038). In the gemcitabine and taxane groups, patients with low programmed cell death protein-1 ligand had a longer progression-free survival than patients with high programmed cell death protein-1 ligand (P = .047). There was a significant correlation between neutrophil-to-lymphocyte ratio and programmed cell death protein-1 ligand levels. In the groups with high programmed cell death protein-1 ligand, patients with low neutrophil-to-lymphocyte ratio levels had higher overall survival than patients with high neutrophil-to-lymphocyte ratio level (P = .043). Also, there was a significant difference between the overall survival patients with low and high platelet-to-lymphocyte ratio levels (P = .520). CONCLUSION: In patients with metastatic non-small cell lung cancer whose programmed cell death protein-1 ligand levels and neutrophil-to-lymphocyte ratio levels are low, immunogenic chemotherapies such as gemcitabine and taxane can be tried as an alternative treatment.