Cancer Res Treat.  2021 Jan;53(1):199-206. 10.4143/crt.2020.497.

Prognostic Value of Serum Soluble Programmed Death-Ligand 1 and Dynamics During Chemotherapy in Advanced Gastric Cancer Patients

• Park W
• Bang JH
• Nam AR
• Jin MH
• Seo H
• Kim JM
• Oh KS
• Kim TY
• Oh DY

• KMID: 2510661
• DOI: http://doi.org/10.4143/crt.2020.497

Abstract

Purpose
The soluble form programmed death-ligand 1 (sPDL1) has immunosuppressive properties and is being studied as a candidate biomarker for immuno-oncology drug development. We measured the serum sPDL1 at pre-and post-chemotherapy and evaluated its prognostic implication and dynamics during chemotherapy in advanced gastric cancer (GC).
Materials and Methods
We prospectively enrolled 68 GC patients who were candidates for palliative standard first-line chemotherapy, and serially collected blood at baseline and after one cycle of chemotherapy, at the best response and after disease progression. sPDL1 was measured using an enzyme-linked immunosorbent assay. Response to chemotherapy, overall survival (OS), progressionfree survival (PFS) and other prognostic factors including neutrophil-lymphocyte ratio (NLR) were obtained. The cut-off value of sPDL1 levels for survival analysis was found using C-statistics.
Results
The median baseline sPDL1 was 0.8 ng/mL (range, 0.06 to 6.06 ng/mL). The median OS and PFS were 14.9 months and 8.0 months, respectively. sPDL1 and NLR showed a weak positive correlation (Spearman’s rho=0.301, p=0.013). Patients with low levels of sPDL1 at diagnosis (< 1.92 ng/mL) showed a better OS and PFS than patients with a high sPDL1. The baseline sPDL1 before treatment was higher in the progressive disease group than in the stable disease and partial response groups. Patients whose sPDL1 increased after the first cycle of chemotherapy showed worse PFS and OS. Following disease progression, sPDL1 increased compared with the baseline.
Conclusion
sPDL1 at prechemotherapy confers a prognostic value for PFS and OS in GC patients under palliative first-line chemotherapy. Dynamics of sPDL1 during chemotherapy correlates with disease progression.

Keyword

B7-H1 antigen; Stomach neoplasms; Liquid biopsy; Progression-free survival

Figure

• 

  Fig. 1 Comparison of overall survival and progression-free survival according to soluble form programmed death-ligand 1 (sPDL1). (A) The overall survival according to baseline sPDL1 value. (B) The progression-free survival according to baseline sPDL1 value. Patients with lower levels of sPDL1 at baseline showed a better progression-free survival than the patients with a higher level of sPDL1 (median PFS, 8.9 months vs. 6.0 months; p=0.040).

• 

  Fig. 2 Dynamics of soluble form programmed death-ligand 1 (sPDL1). (A) Baseline sPDL1 per response. The baseline sPDL1 before treatment was higher in the progressive disease (PD) group than in the stable disease (SD) and partial response (PR) groups (mean, 2.91, 1.17, 1.19 ng/mL; p=0.019). (B) Dynamics of sPDL1 after progression in patients who have matched sample. The sPDL1 of after progression was higher than baseline. (mean, 1.45 ng/mL vs. 1.24 ng/mL; p=0.029).

Reference

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