Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Dis Markers. 2020 Jun 27;2020:8375348. doi: 10.1155/2020/8375348. eCollection 2020.
Recently, checkpoint inhibition of the PD-1/PD-L1 axis has been shown to be therapeutically relevant in urothelial carcinoma (UC). To evaluate the predictive and prognostic value of PD-L1 on response and survival in UC patients after cystectomy, chemotherapy, or anti-PD-1/PD-L1 therapy, a systematic review of PubMed, Embase, Web of Science, and the Cochrane Library was performed. A total of 2154 patients from 14 published studies were included. In all UC patients after cystectomy, tumour cell (TC) PD-L1 expression was not associated with the OS or PFS. For the subset of patients with organ-confined disease, TC PD-L1 expression significantly predicted OS after cystectomy ( = 0.0004). There was no significant evidence of an association between TC PD-L1 status and ORR or OS for UC patients treated with platinum-based chemotherapy. For UC patients treated with anti-PD-1/PD-L1 therapy, TC PD-L1 expression ≥ 5% could predict the response ( = 0.005), but not for the 1% cut-off ( ≥ 0.05). As for PD-L1 expression in tumour-inflating immune cells (TIICs), both subsets with IC2/3 vs. IC0/1 and IC1/2/3 vs. IC0 were associated with ORR to anti-PD-1/PD-L1 therapy. In the TIIC subset, IC2/3 vs. IC0/1 of PD-L1 was associated with higher CR ( = 0.002), PR ( = 0.04), and PD ( = 0.007). Further, higher TIIC PD-L1 status benefited from longer PFS ( < 0.001), but was not associated with OS in UC patients with anti-PD-1/PD-L1 therapy. Our study suggested that TIIC PD-L1 expression with 5% cut-off was valuable as a predictive and prognostic biomarker for ORR and PFS in UC patients with anti-PD-1/PD-L1 therapy.
最近，PD-1/PD-L1 轴的检查点抑制在尿路上皮癌（UC）中显示出治疗相关性。为了评估 PD-L1 在 UC 患者接受膀胱切除术、化疗或抗 PD-1/PD-L1 治疗后的反应和生存中的预测和预后价值，对 PubMed、Embase、Web of Science 和 Cochrane 图书馆进行了系统评价。共纳入来自 14 项已发表研究的 2154 名患者。在所有接受膀胱切除术的 UC 患者中，肿瘤细胞（TC）PD-L1 表达与 OS 或 PFS 无关。对于局限于器官的疾病亚组，TC PD-L1 表达显著预测了膀胱切除术后的 OS（ = 0.0004）。TC PD-L1 状态与接受铂类化疗的 UC 患者的 ORR 或 OS 之间没有显著的关联证据。对于接受抗 PD-1/PD-L1 治疗的 UC 患者，TC PD-L1 表达≥5%可预测反应（ = 0.005），但 1%的截断值（≥0.05）不行。对于肿瘤浸润免疫细胞（TIIC）中的 PD-L1 表达，IC2/3 与 IC0/1 以及 IC1/2/3 与 IC0 两个亚组均与抗 PD-1/PD-L1 治疗的 ORR 相关。在 TIIC 亚组中，IC2/3 与 IC0/1 的 PD-L1 与更高的 CR（ = 0.002）、PR（ = 0.04）和 PD（ = 0.007）相关。此外，较高的 TIIC PD-L1 状态受益于更长的 PFS（<0.001），但与接受抗 PD-1/PD-L1 治疗的 UC 患者的 OS 无关。我们的研究表明，5%截断值的 TIIC PD-L1 表达作为抗 PD-1/PD-L1 治疗的 UC 患者 ORR 和 PFS 的预测和预后生物标志物具有价值。
