Prognostic value of programmed death-ligand 1 in sarcoma: a meta-analysis

Abstract

BackgroundThe prognostic role of programmed death-ligand 1 (PD-L1) in sarcoma remains controversial. We performed a meta-analysis so as to investigate the impact of PD-L1 on clinicopathlogical findings and survival outcomes in sarcoma.Materials and MethodsA comprehensive search in PubMed, Embase and the Cochrane Library was conducted for relevant studies. The odds ratios or hazard ratios, at 95% confidence intervals were used as measures for investigation of the correlation between PD-L1 expression and clinicopathlogical features or survival outcomes.ResultsFourteen eligible studies comprising 868 patients were selected for analysis. Pooled hazard ratios indicated that the association of PD-L1 expression with overall survival in bone sarcoma (osteosarcoma and chondrosarcoma) patients was statistically significant (1.987, 95% CI: 1.224–3.224, p = 0.005), as was its association with event-free survival in bone and soft-tissue sarcoma patients (3.868, 95% CI: 2.298–6.511, p = 0.000). Additionally, the expression of PD-L1 was positively correlated with the infiltration of programmed death 1 (PD-1) positive T-lymphocytes (OR: 4.012, 95% CI: 2.391–6.733, p = 0.000).ConclusionsOur meta-analysis indicated that high PD-L1 expression is likely to be a negative factor for patients with sarcomas and that it predicts worse survival outcomes.

Expression patterns of PD-L1 and PD-1 provide rationales for immune checkpoint inhibition in soft tissue sarcomas

“…Across all STS subtypes with ≥6 samples, the rate of PD-1 positive samples in PD-L1 expressing ones was higher than in the negative ones. These results are supported by previous studies in smaller STS cohorts or single STS subtypes demonstrating a PD-L1 and PD-1 interaction 13,14,17,21 , which collectively provide a strong rationale that PD-L1 positive patients are eligible for immune checkpoint inhibitor therapy. Furthermore, our findings support the hypothesis that cancer cells can dynamically increase PD-L1 expression to protect themselves in settings of increased numbers of TILs 12 .…”

“…The cohort comprised six distinct and representative STS subtypes, including the three most common subtypes in adults (UPS, liposarcoma, leiomyosarcoma) with ≥47 samples, and additional 22 mixed STS cases. Thus, to the best of our knowledge, our analyses were based on the largest and most comprehensive STS cohort to date13,17 .For MPNST not any sample was scored as positive for PD-L1, for angiosarcomas 50%, which indicates a strong variability of PD-L1 expression depending on the STS subtype. However, it should be noted that for both subtypes showing extreme variability of PD-L1 only a limited number of samples (11 and 6, respectively) were available.…”

The contribution of immune infiltrates and the local microenvironment in the pathogenesis of osteosarcoma

“…Similarly, osteosarcoma cells express B7-H3 which is correlated with the aggressiveness of the disease and metastatic capacity [85,86]. Program Death Ligand-1 (PDL-1) and PDL-2 were also detectable in all osteosarcoma cases [89][90][91][92][93][94].…”

Prognostic impact of programmed cell death ligand 1 expression on long‑term oncologic outcomes in colorectal cancer

“…PD-L1 expression in tumor cells may be linked to a weakened host immune response, resulting in immune escape and an adverse prognosis in several malignancies ( 20 – 22 ). However, the prognostic role of PD-L1 expression in CRC is less clear, with some studies reporting conflicting results as to whether PD-L1 expression indicates a better or worse prognosis.…”