PD-L1 predicts poor prognosis for nasopharyngeal carcinoma irrespective of PD-1 and EBV-DNA load

Abstract

Programmed death-1 (PD-1) is an immunosuppressive receptor functionally bound with programmed death-ligand 1 (PD-L1), which has been reported in various malignancies. However, only a few studies are available for the clinical significance of PD-1/PD-L1 in nasopharyngeal carcinoma (NPC). In this study, we aim to investigate alterations in PD-1/PD-L1 by using immunohistochemistry analysis in a cohort of consecutively enrolled NPC patients (n = 99). To further analyse the correlation between PD-1/PD-L1 and factors involved in clinico-pathology, haematologic biomarkers, EBV-DNA load and outcomes, we collected clinical data for statistical analysis. We observed that lower haemoglobin (HB) and Body Mass Index (BMI) levels were associated with high levels of PD-L1 staining in NPC patients. Importantly, our results suggested that PD-L1 might be a negative indicator for NPC patients. In contrast, a correlation between the PD-1/PD-L1 level and EBV load was not identified. Moreover, PD-1 positivity was suggested to not be significantly correlated with clinical outcomes. Taken together, our results revealed that PD-L1 might be a potential prognostic biomarker for NPC patients. However, further studies are needed to clarify the underlying mechanism of EBV status in the immunosuppression process induced by the PD-1/PD-L1 axis.

The Prognostic Significance of the Tumor-infiltrating Programmed Cell Death-1+ to CD8+ Lymphocyte Ratio in Patients with Colorectal Cancer

“…Previous studies have suggested that the number of PD-1 + TILs is associated with the survival in patients with breast cancer and gastric cancer (21,22). However, others have suggested that the number of PD-1 + TILs was not associated with the survival in patients with nasopharyngeal carcinoma (23). In the present study, there were no relationships between the number of PD-1 + TILs and survival.…”

Immune checkpoint inhibitors in advanced nasopharyngeal carcinoma: Beyond an era of chemoradiation?

“…Given the risk of immune‐related adverse events with treatment, having an accurate biomarker is a step towards personalizing immunotherapy that could mitigate this risk by allowing stratification of clinical responders and influence further patient treatment selection . Based on recent clinical evidence future trials should analyse PD‐L1 and HLA expression, EBV DNA clearance, Treg infiltration and tumour mutation burden rates . To illustrate this, Figure shows a marked improvement in PFS for the nivolumab NCI‐9742 trial when stratified by loss of HLA expression (1 year PFS 76% [yellow line] vs .…”

PD‐1 and PD‐L1 in locoregionally advanced nasopharyngeal carcinoma: Substudy of a randomized phase III trial

“…The percentage of positive PD‐L1 expression in tumor cells was 76‐100% . Patients with high PD‐L1 expression in tumor cells had worst survival outcomes .…”