PD-L1 Acts as a Promising Immune Marker to Predict the Response to Neoadjuvant Chemotherapy in Breast Cancer Patients.

Abstract

BACKGROUND:

Programmed death ligand 1 (PD-L1) is a negative immune stimulatory molecule that plays a key role in tumor immune escape. We analyzed the clinical value of PD-L1-positive expression in predicting the outcome of breast cancer patients and to establish its role as new biomarker to guide precise treatment.

PATIENTS AND METHODS:

PubMed and Embase were searched for all original English-language articles published before January 30, 2019; all articles reported the predictive and prognostic implications of PD-L1+ in breast cancer. Data were analyzed by Stata SE 12 software.

RESULTS:

The PD-L1+ rate varied from 19.7% to 77.6% in breast cancer patients. Specifically, patients with estrogen receptor-positive, progesterone receptor-positive, luminal A, luminal B, and HER2+ disease subtypes had lower PD-L1 expression, while the PD-L1+ percentages did not follow any trend in patients with Ki-67+, normal-like, HER2 overexpression, and basal-like subtype. In addition, PD-L1+ was observed to be associated with significantly improved pathologic complete response to neoadjuvant chemotherapy (odds ratio = 2.01; 95% confidence interval, 1.35-3.01; P < .05). Using PD-L1+ to predict pathologic response showed obvious accuracy. However, PD-L1+ did not show significant association with risk of higher recurrence or metastasis, or higher death risk (hazard ratio = 0.91, P = .655; hazard ratio = 1.00, P = .995).

CONCLUSION:

PD-L1+ is a promising immune parameter with the potential to predict response to neoadjuvant chemotherapy, but it cannot indicate a higher risk of death, recurrence, or metastasis.

• Authors: Qi Du, Juanjuan Che, Xiaoyue Jiang, Li Li, Xinyu Luo, Qin Li
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 20 Issue 1 Pg. e99-e111 (02 2020) ISSN: 1938-0666 [Electronic] United States
• PMID: 31521537 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• B7-H1 Antigen
• Biomarkers, Tumor
• CD274 protein, human

Topics

• Antineoplastic Combined Chemotherapy Protocols (pharmacology, therapeutic use)
• B7-H1 Antigen (analysis, metabolism)
• Biomarkers, Tumor (analysis, metabolism)
• Breast (immunology, pathology, surgery)
• Breast Neoplasms (immunology, mortality, pathology, therapy)
• Chemotherapy, Adjuvant
• Drug Resistance, Neoplasm (immunology)
• Female
• Humans
• Lymphocytes, Tumor-Infiltrating
• Mastectomy
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local (epidemiology, immunology)
• Predictive Value of Tests
• Prognosis
• Tumor Escape