Prognostic Value of Programmed Death Ligand-1 Expression on Tumor-Infiltrating Immune Cells in Patients Treated with Cisplatin-Based Combination Adjuvant Chemotherapy Following Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Retrospective Cohort Study
- 주제(키워드) adjuvant chemotherapy , bladder cancer , programmed death ligand-1 , recurrence , tumor-infiltrating immune cell
- 주제(기타) Biotechnology & Applied Microbiology
- 주제(기타) Oncology
- 설명문(일반) [Lee, Dong Hyeon] Ewha Womans Univ, Sch Med, Dept Urol, Med Ctr, Seoul, South Korea; [Jeong, Jae Yong] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Urol, Sch Med, Seoul, South Korea; [Song, Wan] Sungkyunkwan Univ, Samsung Med Ctr, Dept Urol, Sch Med, 81 Irwon Ro, Seoul 135710, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 DOVE MEDICAL PRESS LTD
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181465
- 본문언어 영어
- Published As http://dx.doi.org/10.2147/OTT.S291327
초록/요약
Purpose: To investigate the prognostic value of programmed death ligand-1 (PD-L1) expression in tumor-infiltrating immune cells (ICs) in men treated with adjuvant chemotherapy (AC) following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). Materials and Methods: We retrospectively reviewed 219 "high-risk" (>= pT3a and/or pN+) patients who underwent RC and received cisplatin-based AC for MIBC between March 2015 and September 2019. PD-L1 expression was measured using the VENTANA (SP-142) immunohistochemistry assay and categorized into the three groups according to the percentage of the tumor area covered by PD-L1 expression on ICs: ICO (<1%), IC1 (>= 1% and <5%), and IC2/3 (>= 5%). Positive PD-L1 expression was defined as IC2/3 (>= 5%). Kaplan-Meier survival analysis was used to assess recurrence-free survival (RFS), and Cox proportional hazard models were applied to identify factors predicting tumor recurrence. Results: In the entire cohort, the overall prevalence of PD-L1 IC0, IC1, and IC2/3 was 13.2%, 27.4%, and 59.4%, respectively. During the mean follow-up of 32.5 months, tumor recurrence was detected in 115 (52.5%) patients. On multivariable analysis, tumor stage (>= pT3, P=0.032), positive lymph nodes (P=0.001), and positive PD-L1 on ICs (P=0.005) were independent predictors of tumor recurrence. The 3 year RFS was 54.7% in patients with negative PD-L1 and 31.7% in patients with positive PD-L1. Conclusion: PD-L1 is widely expressed in ICs. Positive PD-L1 on ICs was significantly associated with shorter RFS in patients treated with cisplatin-based AC following RC. The present results support the use of adjuvant immunotherapy in "high-risk" patients with PD-L1-expressing ICs.
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