Cancer Res Treat.  2016 Apr;48(2):527-536. 10.4143/crt.2015.249.

Association Between PD-L1 and HPV Status and the Prognostic Value of PD-L1 in Oropharyngeal Squamous Cell Carcinoma

Affiliations
  • 1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. silkahn@skku.edu
  • 2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 6Department of Pathology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Oropharyngeal squamous cell carcinoma (OSCC) has been recognized as an immunosuppressive disease. Various mechanisms have been proposed for immune escape, including dysregulation of immune checkpoints such as the PD-1:PD-L1 pathway. We investigated the expression of programmed cell death-ligand 1 (PD-L1) in HPV-negative and HPV-positive OSCC to determine its prevalence and prognostic relevance.
MATERIALS AND METHODS
Using immunohistochemistry, 133 cases of OSCC were evaluated for expression of PD-L1. Formalin-fixed paraffin-embedded tumor samples were stained with monoclonal antibody (clone 5H1) to PD-L1. PD-L1 positivity was defined as membrane staining in ≥20% of tumor cells. Correlations between PD-L1 expression and HPV status and survival parameters were analyzed.
RESULTS
Of the 133 patients, 68% showed PD-L1 expression, and 67% of patients were positive for p16 expression by immunohistochemistry. No significant difference in PD-L1 expression was observed between HPV(-) and HPV(+) tumors (61% vs. 71%, p=0.274). No significant difference in age, gender, smoking history, location of tumor origin, or stage was observed according to PD-L1 status. With a median follow-up period of 44 months, older age (≥65) (p=0.017) and T3-4 stage (p<0.001) were associated with poor overall survival (OS), whereas PD-L1 expression did not affect OS in univariate and multivariate analysis.
CONCLUSION
PD-L1 expression was observed in the majority of OSCC patients regardless of HPV status. Further large prospective studies are required to determine the role of PD-L1 expression as a prognostic or predictive biomarker, and clinical studies of immune checkpoint inhibitors in OCSS are warranted regardless of HPV status.

Keyword

Programmed death ligand-1 (PD-L1); Human papillomavirus (HPV); Oropharyngeal Neoplasms; Immune checkpoint inhibitor; Immune therapy

MeSH Terms

Carcinoma, Squamous Cell*
Epithelial Cells*
Follow-Up Studies
Humans
Immunohistochemistry
Membranes
Multivariate Analysis
Oropharyngeal Neoplasms
Prevalence
Prospective Studies
Smoke
Smoking
United Nations
Smoke

Figure

  • Fig. 1. Kaplan-Meier curves of overall survival (OS) and progression-free survival (PFS) according to programmed cell death-ligand 1 (PD-L1) expression status in patients with oropharyngeal squamous cell carcinoma. The p-value for difference between the two curves was determined using the log-rank test. (A) OS for overall population. (B) PFS for overall population. (C) OS for the p16-positive group. (D) PFS for the p16-positive group. (E) OS for the p16-negative group. (F) PFS for the p16-negative group.

  • Fig. 2. Kaplan-Meier curves of overall survival (OS) (A) and progression-free survival (PFS) (B) according to p16 expression status in patients with oropharyngeal squamous cell carcinoma.


Cited by  2 articles

Prevalence of high-risk human papillomavirus and its genotype distribution in head and neck squamous cell carcinomas
Yuil Kim, Young-Hoon Joo, Min-Sik Kim, Youn Soo Lee
J Pathol Transl Med. 2020;54(5):411-418.    doi: 10.4132/jptm.2020.06.22.

Prognostic Value of Combined Programmed Cell Death 1 Ligand and p16 Expression Predicting Responsiveness to Radiotherapy in Patients with Oropharyngeal Squamous Cell Carcinoma
Minsu Kwon, Dae Hwan Kim, Ki Ju Cho, Youngchul Kim, Jin Pyeong Kim, Bae Kwon Jeong, Jong Sil Lee, Ji-Hyun Seo, Jung Je Park
Korean J Otorhinolaryngol-Head Neck Surg. 2019;62(12):712-719.    doi: 10.3342/kjorl-hns.2019.00619.


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