PD-L1 expression associates with favorable survival of patients with cancer of unknown primary (CUP) not treated with checkpoint inhibitors.

Autor: Abu Sabbah T; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Theurer S; West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Baba HA; West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Lueong S; German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany; West German Cancer Center, Institute for Developmental Cancer Therapeutics, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Rashidi-Alavijeh J; Department of Gastroenterology, Hepatology and Transplant Medicine, University of Duisburg-Essen, Duisburg, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Hilser T; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Zaun Y; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Metzenmacher M; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Pogorzelski M; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Virchow I; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT) West, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Pretzell I; West German Cancer Center, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Kostbade K; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Treckmann J; West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Wiesweg M; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT) West, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Schuler M; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT) West, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Kasper S; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT) West, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany., Zaun G; West German Cancer Center, Department of Medical Oncology, University Hospital Essen, Essen, Germany; Medical Faculty, University Duisburg-Essen, Essen, Germany. Electronic address: gregor.zaun@uk-essen.de.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2024 Oct; Vol. 210, pp. 114268. Date of Electronic Publication: 2024 Aug 10.
DOI: 10.1016/j.ejca.2024.114268
Abstrakt: Purpose: Cancer of unknown primary (CUP) is a heterogeneous entity with limited overall survival (OS) in most patients. Prognostic biomarkers are needed, particularly for treatment stratification. We investigated the impact of programmed death-ligand 1 (PD-L1) expression as prognostic marker in immunotherapy-naïve CUP patients.
Methods: Clinical data from patients with confirmed CUP diagnosis according to ESMO guidelines, treated at the West German Cancer Center, Essen from 2015 to 2021, were analyzed. Patients treated with checkpoint inhibitors were excluded. PD-L1 expression was assessed in tumor tissues following established guidelines.
Results: Of a cohort of 132 patients, 62 patients, including 30 patients with prognostically unfavorable CUP, met inclusion criteria and were evaluable for PD-L1 expression. Comparing PD-L1 Tumor Proportional Score (TPS) and Combined Positive Score (CPS) revealed almost complete concordance (96.2 %). Patients with PD-L1-positive CUP (TPS ≥1 %; n = 36; 58 %) had superior overall survival (median not reached) as compared to patients with PD-L1-negative CUP (median 14 months, 95 %CI 10.0-18.0; HR 0.3, p < 0.001). The benefit of PD-L1 positivity (n = 12; 40 %) was maintained in the unfavorable CUP subgroup (median 20 months, 95 %CI 3.0-37.0 versus 10 months, 95 %CI 3.1-16.9; HR 0.4, p = 0.032). In PD-L1-positive CUP there was a positive correlation between the level of PD-L1 expression and survival (TPS ≥50 %: median survival not reached, HR 0.1; TPS 1 to 49 %: OS: 77 months, HR 0.4).
Conclusion: PD-L1 expression associates with favorable survival in checkpoint inhibitor-naïve CUP patients. This implies a role of cancer immunity in CUP biology and may nominate PD-L1 for patient stratification in further studies and clinical care.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: