Overexpression of Programmed Death-Ligand 1 Receptor mRNA as an Independent Negative Prognostic Factor for Triple Negative Breast Cancer

Abstract

Background Triple negative breast cancer (TNBC) (represents roughly 25% of all breast cancers in Yogyakarta) still has the worst survival compared to other breast cancer subtypes. Results from recent studies have shown that inhibition of programmed death-ligand 1 receptor (PD-L1) in TNBC patients is associated with better prognosis. Currently, data on PD-L1 expression and its prognostic value in Indonesian TNBC patients are still relatively unknown. This study aimed to investigate the expression of PD-L1 in Indonesian TNBC patients as preliminary proof to support PD-L1 inhibitor as a possible treatment option near in the future. Methods We retrospectively included stage I-III TNBC patients diagnosed between 2014 and 2017 in Dr. Sardjito Hospital, Yogyakarta, Indonesia. Clinical variables were collected from medical record. Paraffin blocks of biopsy specimen were retrieved to examine mRNA level of PD-L1. Results We included 48 subjects with mean age of 51.09 years and mean body mass index (BMI) of 24.58. The 3-year overall survival (OS) was 58.3%. Overexpression of PD-L1 mRNA in TNBC patients is associated with worse prognosis (P < 0.01). There were no statistically significant associations between PD-L1 mRNA expression and any of the clinicopathologic variables examined. Conclusions In summary, PD-L1 mRNA overexpression is associated with worse survival in Indonesian TNBC patients, independent of other established risk factors. PD-L1 mRNA is expressed in all of our samples, presenting as a feasible alternative or complementary method in deciding which patient might benefit from receiving PD-L1 inhibitor.

Expression of Programmed Death Ligand 1 in Breast Cancer in Mexican Women

“…Studies have confirmed the relationships between PD-L1 expression and worse survival; for example, a retrospective study in Indonesia demonstrated that the overexpression of PD-L1 in triple-negative breast cancer patients is associated with worse prognosis, independent of other established risk factors [11]. In our study, we identified a direct relationship between PD-L1 expression and tumor size.…”

Treatment with eFT-508 increases chemosensitivity in breast cancer cells by modulating the tumor microenvironment

“…Patients with TNBC responded better to neoadjuvant chemotherapy; however, OS and PFS still decreased [ 11 , 22 ]. Therefore, there was an urgent need to find alternative treatment strategies.…”

“…PD-1 binds to its two ligands, PD-L1 and PD-L2, which are expressed on the surface of tumor cells [ 10 ]. The breast tumors express PD-L1, and this expression is related to the negative receptor state [ 10 , 11 ]. In addition, studies have found that the treatment effect of patients with TNBC is significantly improved using anti-PD-1/PD-L1 single drug treatment (29,424,936).…”

Penerapan Modalitas Anti-PD-1/PD-L1 pada Pasien KPTN di Indonesia

“…Berdasarkan sebuah studi kohort retrospektif di Yogyakarta, ekspresi mRNA PD-L1 ditemukan pada seluruh pasien KPTN. Pada studi yang sama, 21% dari seluruh subjek menunjukkan overekspresi mRNA PD-L1 pada sel tumor dan merupakan faktor prognostik buruk 12 . Nilai prognostik PD-1/PD-L1 sendiri masih inkonsisten pada berbagai penelitian 13 , namun inhibisi terhadap PD-1/PD-L1 berdampak pada kesintasan yang lebih baik pada pasien KPTN 14 .…”