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Correlation of PD-L1 Expression of Tumor Cells with Survival Outcomes after Radical Intensity-Modulated Radiation Therapy for Non-Metastatic Nasopharyngeal Carcinoma.

Lee VH, Lo AW, Leung CY, Shek WH, Kwong DL, Lam KO, Tong CC, Sze CK, Leung TW - PLoS ONE (2016)

Bottom Line: After a median follow-up of 7.6 years, 21 (20.2%), 19 (18.3%) and 31 (29.8%) patients suffered from locoregional failure, distant metastases and overall disease progression, respectively, and 31 (29.8%) patients died.PD-L1 IHC 2+ was independently prognostic of both LRFFS (P = 0.014) and PFS (P = 0.045) in multivariable analyses.Only induction chemotherapy followed by concurrent chemoradiation was prognostic of DMFS (P = 0.003) and no prognostic factor for OS was identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.

ABSTRACT

Purpose: We investigated if programmed death-ligand 1 (PD-L1) expression levels were prognostic of survival outcomes after intensity-modulated radiation therapy (IMRT) for non-metastatic nasopharyngeal carcinoma (NPC).

Methods and materials: 104 patients with non-metastatic NPC treated with radical IMRT were investigated for their PD-L1 expression by immunohistochemistry (IHC) which were correlated with survival endpoints including locoregional failure-free survival (LRFFS), progression-free survival (PFS), distant metastasis-free survival (DMFS) and overall survival (OS).

Results: After a median follow-up of 7.6 years, 21 (20.2%), 19 (18.3%) and 31 (29.8%) patients suffered from locoregional failure, distant metastases and overall disease progression, respectively, and 31 (29.8%) patients died. Patients whose tumors had PD-L1 IHC 2+ (moderate to strong membrane staining in ≥ 25% of tumor cells) enjoyed longer LRFFS (5-year 100% vs. 74.4%, Hazard ratio [HR], 0.159, 95% confidence interval [CI], 0.021-0.988; P = 0.042) and marginally longer PFS (5-year 95.0% vs. 65.2%, HR, 0.351, 95% CI, 0.08-0.999, P = 0.067) compared to those whose tumors had PD-L1 IHC 0 (minimal membrane staining with PD-L1 in < 5% tumor cells or no staining with PD-L1) or 1+ (minimal to moderate membrane staining with PD-L1 in between 5-24% tumor cells). PD-L1 IHC 2+ was independently prognostic of both LRFFS (P = 0.014) and PFS (P = 0.045) in multivariable analyses. Only induction chemotherapy followed by concurrent chemoradiation was prognostic of DMFS (P = 0.003) and no prognostic factor for OS was identified.

Conclusion: PD-L1 expression levels correlated with LRRFS and PFS in non-metastatic NPC treated with radical IMRT. It may play a role in radiosensitivity for NPC, which should be further confirmed in prospective studies using immunotherapy together with IMRT.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristics curve showing the performance of PD-L1 IHC 2+ as cut-off for locoregional progression of patients with non-metastatic NPC treated with radical intensity-modulated radiation with or without adjunct chemotherapy.
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pone.0157969.g005: Receiver operating characteristics curve showing the performance of PD-L1 IHC 2+ as cut-off for locoregional progression of patients with non-metastatic NPC treated with radical intensity-modulated radiation with or without adjunct chemotherapy.

Mentions: Subgroup analyses revealed that patients whose tumors exhibited PD-L1 IHC 2+ enjoyed a significantly longer LRFFS (5-year 100%, hazard ratio [HR], 0.159, 95% confidence interval [CI], 0.021–0.988; P = 0.042) compared to those whose tumors were PD-L1 IHC 0 or 1+ only (5-year 74.4%) (Fig 4A). Similarly, marginally longer PFS was also seen in those whose tumors exhibited PD-L1 IHC 2+ (5-year 95.0%, HR, 0.351, 95% CI, 0.108–0.999; P = 0.067) compared to those whose tumors was PD-L1 0 or 1+ only (5-year 65.2%) (Fig 4B). No significant differences in DMFS and OS were noticed between patients whose tumors exhibited PD-L1 IHC 2+ and the rest whose tumors exhibited PD-L1 IHC 0 or 1+ only (Fig 4C and 4D), despite a numerical advantage for patients whose tumors demonstrating PD-L1 IHC 2+. ROC analysis showed that the area-under-the-curve (AUC) values for locoregional progression and overall progression was 0.613 (95% CI, 0.479–0.726, P = 0.048) and 0.590 (95% CI, 0.467–0.697, P = 0.059) respectively by using IHC 2+ as the cutoff (Figs 5 and 6).


Correlation of PD-L1 Expression of Tumor Cells with Survival Outcomes after Radical Intensity-Modulated Radiation Therapy for Non-Metastatic Nasopharyngeal Carcinoma.

Lee VH, Lo AW, Leung CY, Shek WH, Kwong DL, Lam KO, Tong CC, Sze CK, Leung TW - PLoS ONE (2016)

Receiver operating characteristics curve showing the performance of PD-L1 IHC 2+ as cut-off for locoregional progression of patients with non-metastatic NPC treated with radical intensity-modulated radiation with or without adjunct chemotherapy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920427&req=5

pone.0157969.g005: Receiver operating characteristics curve showing the performance of PD-L1 IHC 2+ as cut-off for locoregional progression of patients with non-metastatic NPC treated with radical intensity-modulated radiation with or without adjunct chemotherapy.
Mentions: Subgroup analyses revealed that patients whose tumors exhibited PD-L1 IHC 2+ enjoyed a significantly longer LRFFS (5-year 100%, hazard ratio [HR], 0.159, 95% confidence interval [CI], 0.021–0.988; P = 0.042) compared to those whose tumors were PD-L1 IHC 0 or 1+ only (5-year 74.4%) (Fig 4A). Similarly, marginally longer PFS was also seen in those whose tumors exhibited PD-L1 IHC 2+ (5-year 95.0%, HR, 0.351, 95% CI, 0.108–0.999; P = 0.067) compared to those whose tumors was PD-L1 0 or 1+ only (5-year 65.2%) (Fig 4B). No significant differences in DMFS and OS were noticed between patients whose tumors exhibited PD-L1 IHC 2+ and the rest whose tumors exhibited PD-L1 IHC 0 or 1+ only (Fig 4C and 4D), despite a numerical advantage for patients whose tumors demonstrating PD-L1 IHC 2+. ROC analysis showed that the area-under-the-curve (AUC) values for locoregional progression and overall progression was 0.613 (95% CI, 0.479–0.726, P = 0.048) and 0.590 (95% CI, 0.467–0.697, P = 0.059) respectively by using IHC 2+ as the cutoff (Figs 5 and 6).

Bottom Line: After a median follow-up of 7.6 years, 21 (20.2%), 19 (18.3%) and 31 (29.8%) patients suffered from locoregional failure, distant metastases and overall disease progression, respectively, and 31 (29.8%) patients died.PD-L1 IHC 2+ was independently prognostic of both LRFFS (P = 0.014) and PFS (P = 0.045) in multivariable analyses.Only induction chemotherapy followed by concurrent chemoradiation was prognostic of DMFS (P = 0.003) and no prognostic factor for OS was identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.

ABSTRACT

Purpose: We investigated if programmed death-ligand 1 (PD-L1) expression levels were prognostic of survival outcomes after intensity-modulated radiation therapy (IMRT) for non-metastatic nasopharyngeal carcinoma (NPC).

Methods and materials: 104 patients with non-metastatic NPC treated with radical IMRT were investigated for their PD-L1 expression by immunohistochemistry (IHC) which were correlated with survival endpoints including locoregional failure-free survival (LRFFS), progression-free survival (PFS), distant metastasis-free survival (DMFS) and overall survival (OS).

Results: After a median follow-up of 7.6 years, 21 (20.2%), 19 (18.3%) and 31 (29.8%) patients suffered from locoregional failure, distant metastases and overall disease progression, respectively, and 31 (29.8%) patients died. Patients whose tumors had PD-L1 IHC 2+ (moderate to strong membrane staining in ≥ 25% of tumor cells) enjoyed longer LRFFS (5-year 100% vs. 74.4%, Hazard ratio [HR], 0.159, 95% confidence interval [CI], 0.021-0.988; P = 0.042) and marginally longer PFS (5-year 95.0% vs. 65.2%, HR, 0.351, 95% CI, 0.08-0.999, P = 0.067) compared to those whose tumors had PD-L1 IHC 0 (minimal membrane staining with PD-L1 in < 5% tumor cells or no staining with PD-L1) or 1+ (minimal to moderate membrane staining with PD-L1 in between 5-24% tumor cells). PD-L1 IHC 2+ was independently prognostic of both LRFFS (P = 0.014) and PFS (P = 0.045) in multivariable analyses. Only induction chemotherapy followed by concurrent chemoradiation was prognostic of DMFS (P = 0.003) and no prognostic factor for OS was identified.

Conclusion: PD-L1 expression levels correlated with LRRFS and PFS in non-metastatic NPC treated with radical IMRT. It may play a role in radiosensitivity for NPC, which should be further confirmed in prospective studies using immunotherapy together with IMRT.

No MeSH data available.


Related in: MedlinePlus