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Impact of Programmed Death-ligand 1 Expression on Oncological Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Radiation-based Therapy

التفاصيل البيبلوغرافية
العنوان: Impact of Programmed Death-ligand 1 Expression on Oncological Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Radiation-based Therapy
المؤلفون: Gautier Marcq, Gertruda Evaristo, Ronald Kool, Surashri Shinde-Jadhav, Rodrigo Skowronski, José João Mansure, Luis Souhami, Fabio Cury, Fadi Brimo, Wassim Kassouf
المصدر: European Urology Open Science, Vol 43, Iss , Pp 14-21 (2022)
بيانات النشر: Elsevier, 2022.
سنة النشر: 2022
المجموعة: LCC:Diseases of the genitourinary system. Urology
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
مصطلحات موضوعية: Bladder-sparing approach, Muscle-invasive bladder cancer, Programmed Death-Ligand 1, Radiation-based therapy, Tumor microenvironment, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: Background: No biomarkers are recommended for patients undergoing radiation-based therapy (RT) for muscle-invasive bladder cancer (MIBC). Objective: We aim to evaluate the predictive role of programmed death-ligand 1 (PD-L1) expression on the oncological outcomes of patients treated with RT for MIBC. Design, setting, and participants: A single-center retrospective analysis of tumor specimens collected through transurethral resection (TURBT) from 104 MIBC patients, implemented in a tissue microarray and stained with the SP263 PD-L1 clone (Ventana Medical Systems, Tucson, AZ, USA), was conducted. Two reviewers measured the PD-L1 H-score for tumor and immune cells. Intervention: RT (maximal TURBT followed by radiation and concurrent chemotherapy when eligible). Outcome measurements and statistical analysis: Logistic and Cox regression models were used to predict 3-mo complete response (CR) and overall survival (OS) after RT, respectively. Results and limitations: A total of 88 (85%) patients had cT2 disease and 39 (37.5%) had high immune cell PD-L1 expression. A CR was achieved in 68 (65%) patients. On the multivariable analysis (MVA), a higher clinical stage (p = 0.02) and a low immune cell PD-L1 H-score (p = 0.02) were associated with a decreased CR after RT. The median time to death was 43 mo (95% confidence interval 20–66). On Cox MVA, a high immune cell PD-L1 H-score (p = 0.0017) was associated with better OS, independently of performance status (p = 0.0005) or tumor stage (p = 0.0013). A high tumor cell PD-L1 H-score was not an independent predictor of CR or OS. Limitations of the study include the retrospective design. Conclusions: MIBC patients with high PD-L1 expression on immune cells appear to have better oncological outcomes following RT. Our results may aid in patient stratification for future clinical trial design. Patient summary: In this report, we evaluated the role of programmed death-ligand 1 (PD-L1) expressed on tumor and immune cells in the tumor microenvironment for patients treated with a bladder-sparing regimen. We found that PD-L1 overexpression on immune cells is able to predict a better response to radiation-based therapy.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2666-1683
Relation: http://www.sciencedirect.com/science/article/pii/S266616832200725X; https://doaj.org/toc/2666-1683
DOI: 10.1016/j.euros.2022.06.009
URL الوصول: https://doaj.org/article/650cd814add34ed5b4188082200a11c2
رقم الأكسشن: edsdoj.650cd814add34ed5b4188082200a11c2
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:26661683
DOI:10.1016/j.euros.2022.06.009