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The prognostic role of PD-L1 expression for survival in head and neck squamous cell carcinoma: A systematic review and meta-analysis.
Oral Oncol. 2018 11; 86:81-90.OO

Abstract

BACKGROUND

Programmed death-ligand 1 (PD-L1) is an immune checkpoint that is primarily located on the surface of tumor cells. PD-L1 expression detected by immunohistochemistry (IHC) assays has been widely studied to predict survival outcomes in head and neck squamous cell carcinoma (HNSCC) recently. We aimed to review comprehensively the prognostic role of PD-L1 expression for survival in HNSCC.

METHODS

We systematically searched PubMed, Embase, Web of Science, Cochrane Library and Scopus to identify studies investigating the prognostic role of PD-L1 expression in HNSCC. All studies published before March 31, 2018 were screened. Included studies were assessed using the Quality in Prognosis Studies (QUIPS) tool. Data were extracted and overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), disease-specific survival (DSS) were combined and presented as hazard ratios (HR) with 95% confidence interval (CI) using the generic inverse-variance method.

RESULTS

Twenty-three studies with 3105 patients were analysed. The overall positive rate of PD-L1 in HNSCC was 0.42 (95% CI: 0.36-0.48). There was no significant difference between PD-L1-positive and -negative HNSCC patients in OS (HR: 0.98; 95% CI: 0.71-1.37; p = 0.93), DFS (HR: 1.07; 95% CI: 0.68-1.70; p = 0.76), and DSS (HR: 0.90; 95% CI: 0.63-1.29; p = 0.56). An improved PFS was observed in patients with positive PD-L1 expression (HR: 0.71; 95% CI: 0.55-0.93; p = 0.01). In patients with low CD8+ tumor-infiltrating T cells, a poorer OS was detected in patients with positive PD-L1 expression (HR: 1.90; 95% CI: 1.07-3.36; p = 0.03). Patients with HPV-positive HNSCC were associated with increased PD-L1 expression (OR: 1.99; 95% CI: 1.50-2.64; p < 0.001). However, PD-L1 expression showed no significant benefit on OS in HPV-positive HNSCC (HR: 1.04; 95% CI: 0.65-1.65; p = 0.88).

CONCLUSIONS

PD-L1 expression detected by IHC was not recommended to predict survival in HNSCC patients. However, the positive PD-L1 expression might predict better PFS in patients with advanced HNSCC. The combined effects of PD-L1 expression and CD8+ tumor-infiltrating T cells should be further elucidated.

Authors+Show Affiliations

Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region. Electronic address: richsu@hku.hk.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

30409325

Citation

Yang, Wei-Fa, et al. "The Prognostic Role of PD-L1 Expression for Survival in Head and Neck Squamous Cell Carcinoma: a Systematic Review and Meta-analysis." Oral Oncology, vol. 86, 2018, pp. 81-90.
Yang WF, Wong MCM, Thomson PJ, et al. The prognostic role of PD-L1 expression for survival in head and neck squamous cell carcinoma: A systematic review and meta-analysis. Oral Oncol. 2018;86:81-90.
Yang, W. F., Wong, M. C. M., Thomson, P. J., Li, K. Y., & Su, Y. X. (2018). The prognostic role of PD-L1 expression for survival in head and neck squamous cell carcinoma: A systematic review and meta-analysis. Oral Oncology, 86, 81-90. https://doi.org/10.1016/j.oraloncology.2018.09.016
Yang WF, et al. The Prognostic Role of PD-L1 Expression for Survival in Head and Neck Squamous Cell Carcinoma: a Systematic Review and Meta-analysis. Oral Oncol. 2018;86:81-90. PubMed PMID: 30409325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prognostic role of PD-L1 expression for survival in head and neck squamous cell carcinoma: A systematic review and meta-analysis. AU - Yang,Wei-Fa, AU - Wong,May C M, AU - Thomson,Peter J, AU - Li,Kar-Yan, AU - Su,Yu-Xiong, Y1 - 2018/09/17/ PY - 2018/07/02/received PY - 2018/08/27/revised PY - 2018/09/13/accepted PY - 2018/11/10/entrez PY - 2018/11/10/pubmed PY - 2019/12/18/medline KW - HPV KW - Head and neck cancer KW - Meta-analysis KW - PD-L1 KW - Programmed death-ligand 1 KW - Squamous cell carcinoma KW - Survival KW - TIL KW - Tumor-infiltrating lymphocytes SP - 81 EP - 90 JF - Oral oncology JO - Oral Oncol VL - 86 N2 - BACKGROUND: Programmed death-ligand 1 (PD-L1) is an immune checkpoint that is primarily located on the surface of tumor cells. PD-L1 expression detected by immunohistochemistry (IHC) assays has been widely studied to predict survival outcomes in head and neck squamous cell carcinoma (HNSCC) recently. We aimed to review comprehensively the prognostic role of PD-L1 expression for survival in HNSCC. METHODS: We systematically searched PubMed, Embase, Web of Science, Cochrane Library and Scopus to identify studies investigating the prognostic role of PD-L1 expression in HNSCC. All studies published before March 31, 2018 were screened. Included studies were assessed using the Quality in Prognosis Studies (QUIPS) tool. Data were extracted and overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), disease-specific survival (DSS) were combined and presented as hazard ratios (HR) with 95% confidence interval (CI) using the generic inverse-variance method. RESULTS: Twenty-three studies with 3105 patients were analysed. The overall positive rate of PD-L1 in HNSCC was 0.42 (95% CI: 0.36-0.48). There was no significant difference between PD-L1-positive and -negative HNSCC patients in OS (HR: 0.98; 95% CI: 0.71-1.37; p = 0.93), DFS (HR: 1.07; 95% CI: 0.68-1.70; p = 0.76), and DSS (HR: 0.90; 95% CI: 0.63-1.29; p = 0.56). An improved PFS was observed in patients with positive PD-L1 expression (HR: 0.71; 95% CI: 0.55-0.93; p = 0.01). In patients with low CD8+ tumor-infiltrating T cells, a poorer OS was detected in patients with positive PD-L1 expression (HR: 1.90; 95% CI: 1.07-3.36; p = 0.03). Patients with HPV-positive HNSCC were associated with increased PD-L1 expression (OR: 1.99; 95% CI: 1.50-2.64; p < 0.001). However, PD-L1 expression showed no significant benefit on OS in HPV-positive HNSCC (HR: 1.04; 95% CI: 0.65-1.65; p = 0.88). CONCLUSIONS: PD-L1 expression detected by IHC was not recommended to predict survival in HNSCC patients. However, the positive PD-L1 expression might predict better PFS in patients with advanced HNSCC. The combined effects of PD-L1 expression and CD8+ tumor-infiltrating T cells should be further elucidated. SN - 1879-0593 UR - https://www.unboundmedicine.com/medline/citation/30409325/The_prognostic_role_of_PD_L1_expression_for_survival_in_head_and_neck_squamous_cell_carcinoma:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1368-8375(18)30338-5 DB - PRIME DP - Unbound Medicine ER -