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Predictive value of PD-L1 expression to the efficacy of immune checkpoint inhibitors in advanced triple-negative breast cancer: A systematic review and meta-analysis.

作者信息

Qi Yingjie, Yan Xin, Wang Chao, Cao Hui, Liu Guangxuan

机构信息

Department of Pharmacy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.

School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China.

出版信息

Front Pharmacol. 2022 Dec 2;13:1004821. doi: 10.3389/fphar.2022.1004821. eCollection 2022.


DOI:10.3389/fphar.2022.1004821
PMID:36532783
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9755205/
Abstract

Immune checkpoint inhibitors (ICIs) have been an emerging treatment strategy for advanced triple-negative breast cancer (TNBC). Some studies have shown that high expression of programmed death-ligand 1 (PD-L1) can achieve a better response of clinical efficacy. However, the efficacy of ICIs in advanced TNBC remains controversial. In this meta-analysis, we evaluated the correlation of PD-L1 expression with the efficacy of ICIs in patients with advanced TNBC. We conducted a systematic search using four databases until March 2022 to obtain eligible randomized controlled trials (RCTs). The quality of the studies was assessed by the Cochrane risk of bias tool. Hazard ratio (HR) was extracted to evaluate the relationship between PD-L1 expression and progression-free survival (PFS) or overall survival (OS) in patients with advanced TNBC. Five randomized controlled clinical trials (RCTs) with 3104 patients were included in this meta-analysis. The results demonstrated that ICIs could significantly improve the OS (HR 0.77, 95% CI 0.60-0.98, = 0.03) in PD-L1 positive TNBC group. In the subgroup analysis, longer OS was observed (HR: 0.70, 95% CI: 0.60-0.82, = 0.00001) in PD-L1 positive TNBC patients receiving ICIs alone or ICIs combined with nab-paclitaxel. In terms of PFS, PFS was significantly improved (HR: 0.68, 95% CI: 0.58-0.79, < 0.00001) in PD-L1 positive patients receiving first-line ICIs and chemotherapy compared to those with ICIs alone. No significant improvement was observed for OS or PFS in PD-L1 negative group. Our study indicated significant improvement for OS in advanced TNBC with ICIs therapy in the PD-L1 positive status, and ICIs alone or ICIs combined with nab-paclitaxel might be a excellent choice in terms of OS. Although PFS has no significant benefit in PD-L1 positive patients, the subgroup analysis showed that ICIs combined with chemotherapy could achieve the PFS benefit in the first-line treatment. However, further clinical studies are needed to validate our conclusions due to limited relevant research.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/2890c6017a2f/fphar-13-1004821-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/8cd4c12c1d0f/fphar-13-1004821-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/258a5d61d7fb/fphar-13-1004821-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/36b935f5c9b7/fphar-13-1004821-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/52aaed082e26/fphar-13-1004821-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/77ddc520b7b1/fphar-13-1004821-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/78e971ca84e3/fphar-13-1004821-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/f343b185d9b6/fphar-13-1004821-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/2890c6017a2f/fphar-13-1004821-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/8cd4c12c1d0f/fphar-13-1004821-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/258a5d61d7fb/fphar-13-1004821-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/36b935f5c9b7/fphar-13-1004821-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/52aaed082e26/fphar-13-1004821-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/77ddc520b7b1/fphar-13-1004821-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/78e971ca84e3/fphar-13-1004821-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/f343b185d9b6/fphar-13-1004821-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da7/9755205/2890c6017a2f/fphar-13-1004821-g008.jpg

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[1]
Predictive value of PD-L1 expression to the efficacy of immune checkpoint inhibitors in advanced triple-negative breast cancer: A systematic review and meta-analysis.

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[3]
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[4]
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[7]
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[10]
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引用本文的文献

[1]
Revolutionizing breast cancer immunotherapy by integrating AI and nanotechnology approaches: review of current applications and future directions.

Bioelectron Med. 2025-5-30

[2]
PD-1/PD-L1 axis: implications in immune regulation, cancer progression, and translational applications.

J Mol Med (Berl). 2024-8

[3]
Gold nanorods with iron oxide dual-modal bioprobes in SERS-MRI enable accurate programmed cell death ligand-1 expression detection in triple-negative breast cancer.

APL Bioeng. 2023-5-23

[4]
The combined effect and mechanism of antiangiogenic drugs and PD-L1 inhibitor on cell apoptosis in triple negative breast cancer.

Ann Transl Med. 2023-1-31

本文引用的文献

[1]
Androgen receptor activity in T cells limits checkpoint blockade efficacy.

Nature. 2022-6

[2]
Immune Checkpoint Inhibitors Combined With Chemotherapy Compared With Chemotherapy Alone for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis.

Front Oncol. 2021-12-16

[3]
Atezolizumab and pembrolizumab in triple-negative breast cancer: a meta-analysis.

Expert Rev Anticancer Ther. 2022-2

[4]
Expression of PD-L1 and BRCA1 in Triple-Negative Breast Cancer Patients and Relationship with Clinicopathological Characteristics.

Evid Based Complement Alternat Med. 2021-10-22

[5]
circRNA-miRNA-mRNA in breast cancer.

Clin Chim Acta. 2021-12

[6]
Immunotherapy Treatment for Triple Negative Breast Cancer.

Pharmaceuticals (Basel). 2021-8-4

[7]
Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced/metastatic triple-negative breast cancer.

Ann Oncol. 2021-8

[8]
Drug penetration in pediatric brain tumors: Challenges and opportunities.

Pediatr Blood Cancer. 2021-6

[9]
Pembrolizumab versus investigator-choice chemotherapy for metastatic triple-negative breast cancer (KEYNOTE-119): a randomised, open-label, phase 3 trial.

Lancet Oncol. 2021-4

[10]
Immunotherapy in Triple-Negative Breast Cancer.

Cancer J.

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