Standardized Digital Image Analysis of PD-L1 Expression in Head and Neck Squamous Cell Carcinoma Reveals Intra- and Inter-Sample Heterogeneity with Therapeutic Implications.

Autor: Deuss E; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany.; Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center Mainz, 55131 Mainz, Germany., Kürten C; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany., Fehr L; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany., Kahl L; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany., Zimmer S; Institute of Pathology, University Medical Center Mainz, 55131 Mainz, Germany., Künzel J; Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center Mainz, 55131 Mainz, Germany.; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 93053 Regensburg, Germany., Stauber RH; Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center Mainz, 55131 Mainz, Germany.; Institute for Biotechnology, Shanxi University, No. 92 Wucheng Road, Taiyuan 030006, China., Lang S; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany., Hussain T; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany.; Department of Otorhinolaryngology, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany., Brandau S; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, 45147 Essen, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 May 31; Vol. 16 (11). Date of Electronic Publication: 2024 May 31.
DOI: 10.3390/cancers16112103
Abstrakt: For practical reasons, in many studies PD-L1 expression is measured by combined positive score (CPS) from a single tumor sample. This does not reflect the heterogeneity of PD-L1 expression in head and neck squamous cell carcinoma (HNSCC). We investigated the extent and relevance of PD-L1 expression heterogeneity in HNSCC analyzing primary tumors and recurrences (LRs), as well as metastases. Tumor tissue from 200 HNSCC patients was immunohistochemically stained for PD-L1 and analyzed using image-analysis software QuPath v3.4 with multiple specimens per patient. CPS was ≥20 in 25.6% of primary tumors. Intra-tumoral heterogeneity led to a therapeutically relevant underestimation of PD-L1 expression in 28.7% of patients, when only one specimen per patient was analyzed. Inter-tumoral differences in PD-L1 expression between primary tumors and lymph node metastasis (LNM) or LR occurred in 44.4% and 61.5% (CPS) and in 40.6% and 50% of cases (TPS). Overall survival was increased in patients with CPS ≥ 1 vs. CPS < 1 in primary tumors and LNM (hazard ratio: 0.46 and 0.35; p < 0.005); CPS in LR was not prognostic. Our analysis shows clinically relevant intra- and inter-sample heterogeneity of PD-L1 expression in HNSCC. To account for heterogeneity and improve patient selection for immunotherapy, multiple sample analyses should be performed, particularly in patients with CPS/TPS < 1.
Databáze: MEDLINE
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