0 avis
Prognostic value of PD‐L1 and PD ‐1 expression in upper tract urothelial carcinoma patients
Archive ouverte
International audience. Objective: To evaluate the prognostic value of PD-L1 and PD-1 expression in upper tract urothelial carcinoma (UTUC) patients.Materials and methods: A retrospective multicenter study was conducted in 283 UTUC patients treated with radical nephroureterectomy (RNU) between 2000 and 2015 at 10 French hospitals. Immunohistochemistry analyses were performed using 2 mm-core tissue micro-arrays with NAT105® and 28.8® antibodies at a 5% cut-off for positivity on tumor cells and tumor-infiltrating lymphocytes to evaluate PD-L1 and PD-1 expression, respectively. Multivariable Cox regression models were used to determine the independent predictors of recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). Results: Overall, 63 (22.3%) and 220 (77.7%) UTUC patients had PD-L1 positive and negative disease, respectively, while 91 (32.2%) and 192 (67.8%) had PD-1 positive and negative disease, respectively. Patients who expressed PD-L1 or PD-1 were more likely to have ≥pT2(68.3% vs. 49.5%;p=0.009 and 69.2% vs. 46.4%;p<0.001, respectively) and high-grade(90.5% vs. 70.0%;p=0.001 and 91.2% vs. 66.7%; p<0.001, respectively) disease with lymphovascular invasion(52.4% vs. 17.3%;p<0.001 and 39.6% vs. 18.2%;p<0.001, respectively) as compared to those who did not. In multivariable Cox regression analysis adjusting for each other, PD-L1 and PD-1 expression were significantly associated with decreased RFS(HR=1.83;95%CI=[1.09-3.08];p=0.023 and HR=1.59; 95%CI=[1.00-2.54];p=0.049; respectively), CSS (HR=2.73; 95%CI=[1.48-5.04]; p=0.001 and HR=1.96; 95%CI=[1.12-3.45]; p=0.019; respectively) and OS (HR=2.08;95%CI=[1.23-3.53]; p=0.006 and HR=1.71; 95%CI=[1.05-2.78];p=0.031; respectively). In addition, multivariable Cox regression analyses evaluating the four-tier combination of PD-L1 and PD-1 expression showed that only [PD-L1 / PD-1 positive] patients(n=38; 13.4%) had significantly decreased RFS (HR=3.07; 95%CI=[1.70-5.52];p<0.001), CSS (HR=5.23; 95%CI=[2.62-10.43];p<0.001) and OS (HR=3.07; 95%CI=[1.70-5.52]; p<0.001) as compared to those with [PD-L1 / PD-1 negative] disease (n=167; 59.0%). Conclusions: We observed that PD-L1 and PD-1 expression were both associated with adverse pathological features that translated into an independent and cumulative adverse prognostic value in UTUC patients treated with RNU.
Consulter en ligne
Suggestions
Du même auteur
