Department of Oncology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, PR China.
Department of Oncology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, PR China.
Clin Breast Cancer. 2020 Feb;20(1):e99-e111. doi: 10.1016/j.clbc.2019.06.014. Epub 2019 Aug 21.
Programmed death ligand 1 (PD-L1) is a negative immune stimulatory molecule that plays a key role in tumor immune escape. We analyzed the clinical value of PD-L1-positive expression in predicting the outcome of breast cancer patients and to establish its role as new biomarker to guide precise treatment.
PubMed and Embase were searched for all original English-language articles published before January 30, 2019; all articles reported the predictive and prognostic implications of PD-L1 in breast cancer. Data were analyzed by Stata SE 12 software.
The PD-L1 rate varied from 19.7% to 77.6% in breast cancer patients. Specifically, patients with estrogen receptor-positive, progesterone receptor-positive, luminal A, luminal B, and HER2 disease subtypes had lower PD-L1 expression, while the PD-L1 percentages did not follow any trend in patients with Ki-67, normal-like, HER2 overexpression, and basal-like subtype. In addition, PD-L1 was observed to be associated with significantly improved pathologic complete response to neoadjuvant chemotherapy (odds ratio = 2.01; 95% confidence interval, 1.35-3.01; P < .05). Using PD-L1 to predict pathologic response showed obvious accuracy. However, PD-L1 did not show significant association with risk of higher recurrence or metastasis, or higher death risk (hazard ratio = 0.91, P = .655; hazard ratio = 1.00, P = .995).
PD-L1 is a promising immune parameter with the potential to predict response to neoadjuvant chemotherapy, but it cannot indicate a higher risk of death, recurrence, or metastasis.
程序性死亡配体 1（PD-L1）是一种负性免疫刺激分子，在肿瘤免疫逃逸中起关键作用。我们分析了 PD-L1 阳性表达预测乳腺癌患者预后的临床价值，并将其确立为指导精准治疗的新生物标志物。
检索 2019 年 1 月 30 日前发表的所有原始英文文献，检索数据库为 PubMed 和 Embase，均报道 PD-L1 在乳腺癌中的预测和预后意义。采用 Stata SE 12 软件进行数据分析。
乳腺癌患者中 PD-L1 阳性率为 19.7%77.6%。具体而言，雌激素受体阳性、孕激素受体阳性、管腔 A、管腔 B 和 HER2 型患者的 PD-L1 表达水平较低，而 Ki-67、正常样、HER2 过表达和基底样型患者的 PD-L1 百分比没有任何趋势。此外，PD-L1 与新辅助化疗的病理完全缓解显著相关（比值比=2.01，95%置信区间，1.353.01；P<0.05）。使用 PD-L1 预测病理反应具有明显的准确性。然而，PD-L1 与较高的复发或转移风险或较高的死亡风险无显著相关性（风险比=0.91，P=0.655；风险比=1.00，P=0.995）。
PD-L1 是一种很有前途的免疫参数，具有预测新辅助化疗反应的潜力，但不能提示更高的死亡、复发或转移风险。
