Expression of programmed death ligand-1 predicts poor outcome in nasopharyngeal carcinoma

Abstract

Abstract. Programmed death ligand-1 (PD-L1) is a potentially important tumor immunotherapy target. However, whether PD-L1 expression is associated with survival in nasopharyngeal carcinoma (NPC) remains controversial. The aim of the present study was to investigate the association between PD-L1 expression and prognosis in NPC. The expression of PD-L1 was assessed in tumor specimens from 120 patients with NPC using immunohistochemistry. Staining was evaluated using the H-score method. The associations between PD-L1 expression and clinical characteristics and prognosis were analyzed. Overall, 78% of the patients had stage I-III and 22% had stage IV disease. The estimated 5-year overall survival (OS) and disease-free survival (DFS) rates for the entire cohort were 87.5 and 70.1%, respectively. PD-L1 expression was detected in 85 (71%) patients and was localized to the tumor cells. High tumor expression of PD-L1 (median H-score ≥5) was associated with significantly poorer OS (P=0.023) and DFS (P=0.002). Univariate analysis indicated that low PD-L1 expression was associated with better DFS compared with high PD-L1 expression (HR=0.163, 95% CI: 0.044-0.600, P=0.006 for DFS). Multivariate analysis revealed that T stage (HR=8.190, P=0.023) and PD-L1 expression level (HR=0.124, 95% CI: 0.031-0.509; P=0.001) served as independent prognostic factors for DFS. In conclusion, tumor PD-L1 expression was found to be a significant prognostic factor in NPC, and high PD-L1 expression may be of prognostic value for recurrence and metastasis following conventional treatments.

Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy

“…Previous studies on the clinical significance of PD-L1 expression in NPC showed conflicting results [ 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. The EBV status could influence their results, since all previous studies either worked on a mixed cohort of EBV-positive and EBV-negative cases or did not show results of EBV-encoded small RNAs (EBER) in situ hybridization.…”

“…Recently, a monoclonal anti-PD-1 antibody pembrolizumab has been shown to exhibit anti-tumor effects in patients with PD-L1-positive NPC [ 18 ]. However, the clinical significance of PD-L1 expression in NPC remains controversial, with previous studies showing conflicting conclusions [ 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. In the present study, we evaluated the clinical significance of PD-L1 expression on tumor cells (TCs) and immune cells (ICs) in 208 NPC patients who underwent radiation-based therapy.…”

Expression and clinical significance of programmed death ligand 1 in nasopharyngeal carcinoma

“…Frigola et al (17) indicated that the expression of PD-L1 was associated with the tumor stage and prognosis in patients with renal cell carcinoma. Li et al (23) reported that high tumor expression of PD-L1 was associated with significantly poorer OS and DFS. Compared with other types of head and neck tumor, NPC has a higher risk of metastasis.…”

Rediscovery of NF‐κB signaling in nasopharyngeal carcinoma: How genetic defects of NF‐κB pathway interplay with EBV in driving oncogenesis?

“…It has been demonstrated that NF‐κB activation contribute to LMP‐1 mediated induction of PD‐L1 in NPC cells and natural killer/T‐cell lymphoma (Bi et al, ; Fang et al, ) (Figure ). However, the relationship between PD‐L1 expression and NPC clinical outcomes is remain controversial (Li, Ding, et al, ; Zhu et al, ). A latest clinical trial result revealed that Keytruda (Pembrolizumab) exert antitumor activity with a manageable safety in recurrent or metastatic nasopharyngeal carcinoma (RM‐NPC) patients with PD‐L1 expression (Hsu et al, ).…”