Clinical impact of PD-L1 and PD-1 expression in squamous cell cancer of the vulva.

Abstract

PURPOSE:

Squamous cell carcinoma of the vulva (SQCV) is the fifth most common cancer in women and accounts for about 5% of all genital cancers in women. The PD-L1 signaling pathway is activated in many malignant neoplasms and its blockade enhances anti-cancer immunity. The aim of our study was to examine the protein expression of PD-L1 and PD-1 in squamous cell cancer of the vulva, its correlations with clinicopathologic features and prognostic value.

METHODS:

Patients with SQCV treated in one institution were used for the analyses. PD-L1 immunohistochemistry was performed on 4 µm-thick section of the respective FFPE tissue blocks using the 28-8 antibody. PD-L1 scoring was performed separately for tumour cells (TC) and tumour associated immune cells. DNA was extracted to determine HPV status. Kaplan-Meier estimates for disease-free-survival and overall-survival were calculated and compared by log-rank test.

RESULTS:

PD-L1 expression in tumour cells could be observed in 32.9% of the patients. The expression of PD-L1 in peritumoural immune cells was confirmed in 91.4% of the patients. A significant correlation between PD-L1 expression in tumour cells and tumour stage was detected (p = 0.007). PD-L1 expression was independent from HPV status. Using the log-rank test we could not prove any significant differences in disease-free survival (p = 0.434) and overall survival (p = 0.858). Regression analysis showed that nodal status is a predictive factor of survival (p < 0.001).

CONCLUSION:

The present study showed that a relevant amount of patients with squamous cell cancer of the vulva express PD-L1 in both, tumour cells and tumour-associated immune cells. Furthermore, the significant correlation of PD-L1 expression in TCs with tumour stage indicated the clinical impact of PD-L1 expression during tumour development. These data indicate that SQCV might be amenable to immune checkpoint-inhibition and constitute a rational for the future clinical trials.

• Authors: Fabinshy Thangarajah, Bernd Morgenstern, Caroline Pahmeyer, Lars Mortimer Schiffmann, Julian Puppe, Peter Mallmann, Stefanie Hamacher, Reinhard Buettner, Christina Alidousty, Barbara Holz, Andreas H Scheel, Anne Maria Schultheis
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 145 Issue 6 Pg. 1651-1660 (Jun 2019) ISSN: 1432-1335 [Electronic] Germany
• PMID: 30972492 (Publication Type: Journal Article)

Chemical References

• B7-H1 Antigen
• Biomarkers, Tumor
• CD274 protein, human
• PDCD1 protein, human
• Programmed Cell Death 1 Receptor

Topics

• Aged
• B7-H1 Antigen (biosynthesis, immunology)
• Biomarkers, Tumor (biosynthesis, immunology)
• Carcinoma, Squamous Cell (immunology, metabolism, pathology)
• Female
• Humans
• Immunohistochemistry
• Middle Aged
• Neoplasm Staging
• Prognosis
• Programmed Cell Death 1 Receptor (biosynthesis, immunology)
• Vulvar Neoplasms (immunology, metabolism, pathology)