Combined Association of Tumoral PD-L1 Expression and Pretreatment Presence of Epstein-Barr Virus DNA With Risk Stratification and Prognosis of Patients With Nasopharyngeal Carcinoma

Abstract

BackgroundLittle is known about whether the combination of tumor programmed death-ligand 1 (PD-L1) expression and pretreatment EBV DNA status can help stratify nasopharyngeal carcinoma (NPC) patients by risk of metastasis or predict prognosis.MethodsPD-L1 expression was assessed using immunohistochemical staining of 78 non-keratinizing NPC patients with clinical data. Survival outcomes and independent prognostic factors were identified.ResultsSeventy-eight patients were included, high PD-L1 expression was observed in 25 of 43 patients (58%) with metastasis, while it was observed only in 7 of 35 patients (20%) without metastasis. Multivariate analyses showed that progression-free survival (PFS) was independently predicted by tumoral PD-L1 expression and pretreatment EBV DNA status. When combining, 93.75% patients with high PD-L1 and EBV infection developed distant metastasis, and those patients were associated with worse PFS.ConclusionsBoth PD-L1 expression and pretreatment EBV DNA are closely related to metastasis and prognosis of NPC patients. Their combination can facilitate risk stratification and prognosis prediction, which may improve disease treatment and management.

Frequency of Peripheral CD8+ T Cells Expressing Chemo-Attractant Receptors CCR1, 4 and 5 Increases in NPC Patients with EBV Clearance upon Radiotherapy

“…Therefore, the combination of PD1/PDL1 with other biomarkers such as LAG3 and/or plasma EBV DNA might be clinically significant. This is supported by our study as well as by Li and colleagues, who reported that 93% of patients with detectable pre-treatment plasma EBV DNA and high PDL1 expression were associated with a worse prognosis and multiple studies reporting LAG3 expression to be enriched in dysfunctional T cells in NPC tumors [ 11 , 39 , 46 ]. Myeloid-derived suppressor cells (MDSCs) have been reported to potentially jeopardize the influx and function of T cells and may represent the underlying inducer of these exhausted T cells, which has been reported in RM-NPC patients by Hopkins and colleagues [ 47 ] and is of interest for future studies.…”

Successful use of anti-PD-1 antibody to treat multiple metastatic carcinomas in a patient with xeroderma pigmentosum: case report and literature review

“…CPS is an index of PD-L1 expression and, like TMB and MSI-H, is used to predict the therapeutic effect of pembrolizumab. Several virus-related cancers, including nasopharyngeal carcinoma (caused by Epstein-Barr virus), oropharyngeal carcinoma (caused by human papillomavirus), and Merkel cell carcinoma (caused by Merkel cell polyomavirus) are considered to arise as a result of PD-L1 expression against a background of chronic inflammation [24][25][26]. Chronic inflammation in response to UV exposure may also increase the CPS in patients with XP.…”