Kang Jeongwan, Han Kang Min, Jung Hera, Kim Hyunchul
Department of Pathology, CHA Ilsan Medical Center, 1205 Jungang-ro, Ilsandong-gu, Goyang-si 10414, Republic of Korea.
Diagnostics (Basel). 2023 Oct 19;13(20):3258. doi: 10.3390/diagnostics13203258.
(1) Background: High-grade serous ovarian carcinoma (HGSOC) is an aggressive subtype of ovarian cancer. Recent advances have introduced prognostic markers and targeted therapies. Programmed cell death ligand 1 (PD-L1) has emerged as a potential biomarker for HGSOC, with implications for prognosis and targeted therapy eligibility; (2) Methods: A literature search was conducted on major databases, and extracted data were categorized and pooled. Subgroup analysis was performed for studies with high heterogeneity. (3) Results: Data from 18 eligible studies were categorized and pooled based on PD-L1 scoring methods, survival analysis types, and endpoints. The result showed an association between high PD-L1 expression and a favorable prognosis in progression-free survival (HR = 0.53, 95% CI = 0.35-0.78, = 0.0015). Subgroup analyses showed similar associations in subgroups of neoadjuvant chemotherapy patients (HR = 0.6, 95% CI = 0.4-0.88, = 0.009) and European studies (HR = 0.59, 95% CI = 0.42-0.82, = 0.0017). In addition, subgroup analyses using data from studies using FDA-approved PD-L1 antibodies suggested a significant association between favorable prognosis and high PD-L1 expression in a subgroup including high and low stage data in overall survival data (HR = 0.46, 95% CI = 0.3-0.73, = 0.0009). (4) Conclusions: This meta-analysis revealed a potential association between high PD-L1 expression and favorable prognosis. However, caution is warranted due to several limitations. Validation via large-scale studies, with mRNA analysis, whole tissue sections, and assessments using FDA-approved antibodies is needed.
(1) 背景：高级别浆液性卵巢癌（HGSOC）是卵巢癌的一种侵袭性亚型。近期进展引入了预后标志物和靶向治疗。程序性细胞死亡配体1（PD-L1）已成为HGSOC的一种潜在生物标志物，对预后和靶向治疗适用性具有重要意义；(2) 方法：在主要数据库进行文献检索，对提取的数据进行分类和汇总。对异质性高的研究进行亚组分析。(3) 结果：根据PD-L1评分方法、生存分析类型和终点，对18项符合条件的研究数据进行分类和汇总。结果显示，PD-L1高表达与无进展生存期的良好预后之间存在关联（HR = 0.53，95%CI = 0.35 - 0.78，P = 0.0015）。亚组分析显示，新辅助化疗患者亚组（HR = 0.6，95%CI = 0.4 - 0.88，P = 0.009）和欧洲研究亚组（HR = 0.59，95%CI = 0.42 - 0.82，P = 0.0017）中存在类似关联。此外，使用美国食品药品监督管理局（FDA）批准的PD-L1抗体的研究数据进行的亚组分析表明，在包括总体生存数据中高、低分期数据的亚组中，良好预后与PD-L1高表达之间存在显著关联（HR = 0.46，95%CI = 0.3 - 0.73，P = 0.0009）。(4) 结论：这项荟萃分析揭示了PD-L1高表达与良好预后之间的潜在关联。然而，由于存在若干局限性，仍需谨慎对待。需要通过大规模研究、mRNA分析、全组织切片以及使用FDA批准的抗体进行评估来进行验证。
