Girolami Ilaria, Marletta Stefano, Fiorentino Vincenzo, Battocchio Simonetta, Cerbelli Bruna, Fiamengo Barbara, Gerosa Clara, Gianatti Andrea, Morelli Luca, Riva Giulio, Zagami Maria Giovanna, Fusco Nicola, Munari Enrico, L'Imperio Vincenzo, Pagni Fabio, Morbini Patrizia, Martini Maurizio, Eccher Albino
Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy.
Department of Diagnostics and Public Health, University of Verona, 37124 Verona, Italy.
J Pers Med. 2023 Feb 18;13(2):363. doi: 10.3390/jpm13020363.
Programmed death-ligand 1 (PD-L1) checkpoint inhibitors represent a mainstay of therapy in head and neck squamous cell cancer (HNSCC). However, little is known about the influence of combined therapy on PD-L1 expression. The study aims to gather evidence on this topic.
A systematic search was carried out in electronic databases Pubmed-MEDLINE and Embase to retrieve studies on the comparison of PD-L1 expression before and after conventional therapy. Data were extracted and a quantitative analysis with pooled odds ratios (ORs) was performed when applicable.
Of 5688 items, 15 were finally included. Only a minority of studies assessed PD-L1 with the recommended combined positive score (CPS). The results are highly heterogeneous, with some studies reporting an increase in PD-L1 expression and others reporting a decrease. Three studies allowed for quantitative analysis and showed a pooled OR of 0.49 (CI 0.27-0.90).
From the present evidence, a clear conclusion towards an increase or decrease in PD-L1 expression after combined therapy cannot be drawn, but even with few studies available, a trend towards an increase in expression in tumor cells at a cutoff of 1% can be noted in patients undergoing platinum-based therapy. Future studies will provide more robust data on the effect of combined therapy on PD-L1 expression.
程序性死亡配体1（PD-L1）检查点抑制剂是头颈部鳞状细胞癌（HNSCC）治疗的主要手段。然而，关于联合治疗对PD-L1表达的影响知之甚少。本研究旨在收集有关该主题的证据。
在电子数据库PubMed-MEDLINE和Embase中进行系统检索，以获取关于传统治疗前后PD-L1表达比较的研究。提取数据，并在适用时进行合并比值比（OR）的定量分析。
在5688篇文献中，最终纳入15篇。只有少数研究使用推荐的联合阳性评分（CPS）评估PD-L1。结果高度异质性，一些研究报告PD-L1表达增加，另一些研究报告减少。三项研究进行了定量分析，合并OR为0.49（95%置信区间0.27-0.90）。
根据目前的证据，无法得出联合治疗后PD-L1表达增加或减少的明确结论，但即使研究数量有限，在接受铂类治疗的患者中，可注意到肿瘤细胞中表达增加的趋势，截止值为1%。未来的研究将提供关于联合治疗对PD-L1表达影响的更有力数据。
