程序性死亡配体1（PD-L1）表达补充了CALGB预后评分系统在恶性胸膜间皮瘤中的作用。
PD-L1 expression complements CALGB prognostic scoring system in malignant pleural mesothelioma.
作者信息
Avilés-Salas Alejandro, Cabrera-Miranda Luis, Hernández-Pedro Norma, Vargas-Lías Diana Sofía, Samtani Suraj, Muñoz-Montaño Wendy, Motola-Kuba Daniel, Corrales-Rodríguez Luis, Martín Claudio, Cardona Andrés F, Palomares-Palomares Cittim B, Arrieta Oscar
机构信息
Pathology Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
出版信息
Front Oncol. 2023 Dec 4;13:1269029. doi: 10.3389/fonc.2023.1269029. eCollection 2023.
BACKGROUND
Programmed death ligand-1 (PD-L1) expression is a predictive biomarker in patients with lung cancer, but its role in malignant pleural mesothelioma (MPM) remains unclear. Evidence suggests that higher PD-L1 expression is correlated with worse survival. CALGB is the main scoring system used to predict the benefit of chemotherapy treatment. This study aimed to determine the prognostic value of PD-L1 expression and its addition to CALGB scoring system in patients with MPM.
METHODS
In this retrospective analysis, we evaluated samples with confirmed locally advanced or metastatic MPM. PD-L1 Tumor Proportional Score (TPS) was determined by immunohistochemistry at diagnosis.
RESULTS
73 patients were included in this study. A cutoff value of 15 was set for a high or low PD-L1 TPS. In total, 71.2% (n=52) and 28.8% (n=21) of individuals harbored low or high PD-L1 expression, respectively. PD-L1 was associated with worse median progression-free Survival (mPFS) [4.9 vs. 10.8 months; HR 2.724, 95% CI (1.44-5.14); p = 0.002] and Overall Survival (OS) [6.0 vs. 20.9 months; HR 6.87, 95% CI (3.4-8.7); p<0.001] compared to patients with PD-L1. Multivariate analysis confirmed that PD-L1 expression was an independent factor for PFS and OS in patients with MPM and CALGB score of 5-6.
CONCLUSION
PD-L1 addition to CALGB scale improves its prognostic estimation of MPM survival and should be considered in future research.
背景
程序性死亡配体1（PD-L1）表达是肺癌患者的一种预测性生物标志物，但其在恶性胸膜间皮瘤（MPM）中的作用仍不清楚。有证据表明，较高的PD-L1表达与较差的生存率相关。CALGB是用于预测化疗治疗获益的主要评分系统。本研究旨在确定PD-L1表达的预后价值及其加入CALGB评分系统对MPM患者的影响。
方法
在这项回顾性分析中，我们评估了确诊为局部晚期或转移性MPM的样本。在诊断时通过免疫组织化学确定PD-L1肿瘤比例评分（TPS）。
结果
本研究纳入73例患者。将PD-L1 TPS的高低分界值设定为15。总体而言，分别有71.2%（n = 52）和28.8%（n = 21）的个体PD-L1表达低或高。与PD-L1表达低的患者相比，PD-L1与更差的中位无进展生存期（mPFS）[4.9个月对10.8个月；风险比（HR）2.724，95%置信区间（CI）（1.44 - 5.14）；p = 0.002]和总生存期（OS）[6.0个月对20.9个月；HR 6.87，95% CI（3.4 - 8.7）；p < 0.001]相关。多因素分析证实，PD-L1表达是MPM患者且CALGB评分为5 - 6时PFS和OS的独立因素。
结论
将PD-L1加入CALGB量表可改善其对MPM生存的预后估计，未来研究应予以考虑。
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