Jin Ying, Zhao Jun, Shi Xun, Yu Xinmin
Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
J Cancer Res Ther. 2015 Aug;11 Suppl 1:C38-43. doi: 10.4103/0973-1482.163837.
A great deal of research have been performed to explore the prognostic value of programed death ligand 1 (PD-L1) in solid tumors in last decades. However, the results still remain inconsistent. To clarify a precise determinant of the clinical significance of PD-L1, we conducted a meta-analysis to evaluate the overall risk of PD-L1 on survival for patients with solid tumors.
Related studies were identified through multiple search strategies from PubMed, Embase, and Cochrane databases. Data were collected from studies comparing overall survival (OS) in patients with positive PD-L1 and those having a negative expression. The meta-analysis was performed by Stata version 11.0 (Stata Corporation, College Station, TX, USA). The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.
A total of 14 eligible studies involved 2916 patients were included in our meta-analysis. A summary HRs of all studies and subgroup HRs were calculated. The combined HRs suggested that a positive PD-L1 expression had an unfavorable impact on OS (1.67, 95% CI 1.30-2.16; P < 0.001). Similar results were also observed in subgroup analysis, according to tumor types, regions, patients' number, and publication year.
With the available evidence, PD-L1 might serve as an efficient prognostic indicator in solid tumor and may represent the important new therapeutic target. More prospective studies are now needed to confirm the clinical utility of PD-L1 as an independent prognostic marker.
在过去几十年中,已经进行了大量研究来探索程序性死亡配体1(PD-L1)在实体瘤中的预后价值。然而,结果仍然不一致。为了阐明PD-L1临床意义的确切决定因素,我们进行了一项荟萃分析,以评估PD-L1对实体瘤患者生存的总体风险。
通过多种检索策略从PubMed、Embase和Cochrane数据库中识别相关研究。数据收集自比较PD-L1阳性患者和阴性表达患者总生存期(OS)的研究。荟萃分析使用Stata 11.0版本(美国德克萨斯州大学站的Stata公司)进行。根据纳入试验的异质性,采用固定效应或随机效应模型计算合并风险比(HRs)和95%置信区间(95% CIs)。
我们的荟萃分析共纳入了14项涉及2916例患者的合格研究。计算了所有研究的汇总HRs和亚组HRs。合并HRs表明,PD-L1阳性表达对OS有不利影响(1.67,95% CI 1.30-2.16;P < 0.001)。在根据肿瘤类型、地区、患者数量和发表年份进行的亚组分析中也观察到了类似结果。
根据现有证据,PD-L1可能是实体瘤中一种有效的预后指标,可能代表重要的新治疗靶点。现在需要更多的前瞻性研究来证实PD-L1作为独立预后标志物的临床应用价值。