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
Pathology Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
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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