Ayoub Nehad M, Fares Mona, Marji Raya, Al Bashir Samir M, Yaghan Rami J
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, 22110, Jordan.
Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
Breast Cancer (Dove Med Press). 2021 Nov 13;13:603-615. doi: 10.2147/BCTT.S333123. eCollection 2021.
Tumor expression of programmed death-ligand 1 (PD-L1) is associated with evasion of immune response in several types of malignancies and such expression may render patients eligible for PD-L1 inhibitors. The use of immune checkpoint blockade therapy has been recently approved for the treatment of breast cancer. However, PD-L1 expression data are lacking among Jordanian breast cancer patients. In this study, the tumor PD-L1 expression was characterized in breast cancer patients to assess their eligibility for immune checkpoint blockade therapy. The study also aimed to explore the association between tumoral PD-L1 expression and the clinicopathologic characteristics and the prognostic factors in patients with breast cancer.
Tissue samples were available from 153 female patients with primary invasive breast cancer. Immunohistochemistry was performed on paraffin-embedded tumor sections that were stained with a PD-L1 antibody. Expression of tumor PD-L1 was correlated with demographics, clinicopathologic characteristics, and prognosis.
The mean age at diagnosis was 54.2±12.8 years (median 52, interquartile range 45-65). The percentage of PD-L1-positive tumors was 26.1%. PD-L1 expression on tumor cells significantly and positively correlated with tumor size (rho=0.174, p=0.032). PD-L1 positivity was significantly associated with the grade of carcinoma (p=0.001), HER2-positivity (p=0.015), and lymphovascular invasion (p=0.036). PD-L1 intensity was significantly associated with tumor stage (p=0.046). No significant associations were observed for the PD-L1 expression status or intensity with patient menopausal status, hormone receptor expression, and molecular subtypes. PD-L1 expression significantly correlated with a worse prognosis of breast cancer patients at the time of diagnosis (rho=0.230, p=0.005).
Tumor PD-L1 expression was associated with advanced clinicopathologic features and worse prognosis in this cohort of Jordanian breast cancer patients. Future studies are needed to better understand the impact of PD-L1 blockade therapy on treatment outcomes in eligible breast cancer patients in Jordan.
程序性死亡配体1（PD-L1）在肿瘤中的表达与多种恶性肿瘤免疫反应的逃避相关，这种表达可能使患者适合使用PD-L1抑制剂。免疫检查点阻断疗法最近已被批准用于治疗乳腺癌。然而，约旦乳腺癌患者中缺乏PD-L1表达数据。在本研究中，对乳腺癌患者的肿瘤PD-L1表达进行了特征分析，以评估他们是否适合免疫检查点阻断疗法。该研究还旨在探讨肿瘤PD-L1表达与乳腺癌患者临床病理特征及预后因素之间的关联。
收集了153例原发性浸润性乳腺癌女性患者的组织样本。对用PD-L1抗体染色的石蜡包埋肿瘤切片进行免疫组织化学检测。肿瘤PD-L1的表达与人口统计学、临床病理特征及预后相关。
诊断时的平均年龄为54.2±12.8岁（中位数52岁，四分位间距45 - 65岁）。PD-L1阳性肿瘤的比例为26.1%。肿瘤细胞上的PD-L1表达与肿瘤大小显著正相关（rho = 0.174，p = 0.032）。PD-L1阳性与癌分级（p = 0.001）、HER2阳性（p = 0.015）及淋巴管浸润（p = 0.036）显著相关。PD-L1强度与肿瘤分期显著相关（p = 0.046）。未观察到PD-L1表达状态或强度与患者绝经状态、激素受体表达及分子亚型之间存在显著关联。PD-L1表达与诊断时乳腺癌患者的较差预后显著相关（rho = 0.230，p = 0.005）。
在这组约旦乳腺癌患者中，肿瘤PD-L1表达与晚期临床病理特征及较差预后相关。未来需要开展研究，以更好地了解PD-L1阻断疗法对约旦符合条件的乳腺癌患者治疗结果的影响。
