Programmed Cell Death Ligand 1 Expression in Resected Lung Adenocarcinomas: Association with Immune Microenvironment  Tiffany G. Huynh, BA, Vicente Morales-Oyarvide,

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Programmed Cell Death Ligand 1 Expression in Resected Lung Adenocarcinomas: Association with Immune Microenvironment  Tiffany G. Huynh, BA, Vicente Morales-Oyarvide, MD, MPH, Meghan J. Campo, MD, Justin F. Gainor, MD, Emine Bozkurtlar, MD, Hironori Uruga, MD, PhD, Ling Zhao, MD, Maria Gomez-Caraballo, BA, Aaron N. Hata, MD, PhD, Eugene J. Mark, MD, Michael Lanuti, MD, Jeffrey A. Engelman, MD, PhD, Mari Mino-Kenudson, MD  Journal of Thoracic Oncology  Volume 11, Issue 11, Pages 1869-1878 (November 2016) DOI: 10.1016/j.jtho.2016.08.134 Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Representative images of programmed cell death ligand 1 (PD-L1) and CD8 immunostaining in lung adenocarcinomas (magnification, ×200). A-C show membranous staining of PD-L1 on no (<1%), 20% (≥5% to <50%), and 100% (≥50%) of tumor cells, respectively. D and G show PD-L1 expression in <1% and 20% (≥10%) of stromal immune cells, respectively. Cytoplasmic expression of CD8 in tumor infiltrating T cells is graded as 0, 1 (E), 2 (H), and 3, and is subsequently dichotomized into negative (0–1) and positive (2–3). CD8+ stomal cells are assessed based on the percentage of positive lymphocytes compared with the total number of nucleated cells in the stromal compartments and are dichotomized into negative (≤10% of stromal nuclei, F) and positive (>10% of stromal nuclei, I). Journal of Thoracic Oncology 2016 11, 1869-1878DOI: (10.1016/j.jtho.2016.08.134) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Programmed cell death ligand 1 H score stratified by molecular alterations. H scores of KRAS mutants, those with other molecular alterations and SNaPshot wild-type cases (None) are significantly higher than those of EGFR and ALK mutants (p < 0.0001, p < 0.01, and p < 0.001 for both, respectively). Journal of Thoracic Oncology 2016 11, 1869-1878DOI: (10.1016/j.jtho.2016.08.134) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Kaplan-Meier curves showing progression-free survival (PFS) and overall survival (OS) of lung adenocarcinoma patients with positive and negative programmed cell death ligand 1 (PD-L1; expression for 5% cutoff). (A) Patients who have PD-L1 expression on ≥5% of tumor cells had a lower 5-year PFS rate than those without (66% versus 75%, log-rank p = 0.007). The median PFS for both groups was undefined. (B) Similarly, patients with positive PD-L1 expression had a lower 5-year OS rate than those with negative PD-L1 expression (72% vs. 85%, log-rank p = 0.011). The median OS for both groups was undefined. Journal of Thoracic Oncology 2016 11, 1869-1878DOI: (10.1016/j.jtho.2016.08.134) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Supplementary Figure 1 Journal of Thoracic Oncology 2016 11, 1869-1878DOI: (10.1016/j.jtho.2016.08.134) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Supplementary Figure 2 Journal of Thoracic Oncology 2016 11, 1869-1878DOI: (10.1016/j.jtho.2016.08.134) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions