Chintakuntlawar Ashish V, Rumilla Kandelaria M, Smith Carin Y, Jenkins Sarah M, Foote Robert L, Kasperbauer Jan L, Morris John C, Ryder Mabel, Alsidawi Samer, Hilger Crystal, Bible Keith C
Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota 55905.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905.
J Clin Endocrinol Metab. 2017 Jun 1;102(6):1943-1950. doi: 10.1210/jc.2016-3756.
Anaplastic thyroid cancer (ATC) is rare and a highly fatal malignancy. The role of programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) as prognostic and/or predictive markers in ATC is unknown.
Multimodal therapy offers the best chance at tumor control. The objective of this study was to detect potential associations of PD-1/PD-L1 axis variables with outcome data in ATC.
Retrospective study of a uniformly treated cohort.
Single institution retrospective cohort study.
Sixteen patients who received intensity-modulated radiation therapy (15 had preceding surgery) were studied.
Patients treated with multimodal therapy were followed and assessed for overall survival (OS) and progression-free survival (PFS).
All samples demonstrated PD-1 expression in inflammatory cells whereas tumor cells were primarily negative. PD-L1 was expressed on ATC tumor cells in most samples and showed mainly membranous staining. High PD-1 expression (>40% staining) in inflammatory cells was associated with worse overall survival (OS; hazard ratio, 3.36; 95% confidence interval, 1.00 to 12.96; P < 0.05) and trended toward worse PFS, whereas high PD-L1 expression in tumor cells (>33% staining) trended toward worse PFS and OS.
PD-1/PD-L1 pathway proteins are highly expressed in ATC tumor samples and appear to represent predictive markers of PFS and OS in multimodality-treated ATC patients.
间变性甲状腺癌（ATC）罕见且是一种高度致命的恶性肿瘤。程序性死亡蛋白1（PD-1）和程序性死亡配体1（PD-L1）作为ATC的预后和/或预测标志物的作用尚不清楚。
多模式治疗提供了控制肿瘤的最佳机会。本研究的目的是检测PD-1/PD-L1轴变量与ATC结局数据之间的潜在关联。
对一组接受统一治疗的队列进行回顾性研究。
单机构回顾性队列研究。
研究了16例接受调强放射治疗的患者（15例之前接受过手术）。
对接受多模式治疗的患者进行随访，并评估总生存期（OS）和无进展生存期（PFS）。
所有样本均显示炎症细胞中有PD-1表达，而肿瘤细胞主要为阴性。大多数样本中，PD-L1在ATC肿瘤细胞上表达，主要呈膜性染色。炎症细胞中高PD-1表达（>40%染色）与较差的总生存期（OS；风险比，3.36；95%置信区间，1.00至12.96；P<0.05）相关，且无进展生存期有变差趋势，而肿瘤细胞中高PD-L1表达（>33%染色）无进展生存期和总生存期有变差趋势。
PD-1/PD-L1通路蛋白在ATC肿瘤样本中高表达，似乎代表了多模式治疗的ATC患者无进展生存期和总生存期的预测标志物。
