# Programmed death ligand-1 (PD-L1) is an independent negative prognosticator in Western-world gallbladder cancer

Source: https://onco.cc/key-papers/paper-albrecht-pdl1-western-gallbladder-cancers-2021/  
OnCo record `paper-albrecht-pdl1-western-gallbladder-cancers-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In 131 German gallbladder cancers about one in seven had PD-L1 on tumour cells and fewer than one in twenty had a lot; high PD-L1 marked poorly differentiated tumours and shorter survival, and a second checkpoint, TIGIT, was present in some.

## Summary

PD-L1 was assessed immunohistochemically in 131 gallbladder cancer patients as tumour proportion score (TPS), immune cell score and combined positive score. Tumour cells expressed PD-L1 in 14.7% of patients at a TPS cut-off of 1%; TPS above 10% and 25% was reached in 4.7% and 3.1%. At the 10% cut-off, TPS was associated with distinct histomorphological subtypes and poor differentiation.

Survival analysis showed a TPS above 10% to be a highly significant and independent negative prognosticator. PD-L1 expression was associated with increased CD4-positive, CD8-positive and PD-1-positive immune cell densities. In 14.8% of cases scattered immune cells expressed TIGIT, correlated with tumour expression of its ligand CD155.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Cancers
- Year: 2021
- DOI: 10.3390/cancers13071682
- Authors: Albrecht T, Brinkmann F, Albrecht M, et al.
- Findings: PD-L1 TPS 1% or more in 14.7%, above 10% in 4.7%, above 25% in 3.1% of 131 Western gallbladder cancers.; TPS above 10% an independent negative prognostic factor, linked to poor differentiation and denser CD4, CD8 and PD-1 infiltrates.; TIGIT on scattered immune cells in 14.8%, correlated with tumoral CD155.
- What it means: The Western counterpart to the Indian series, with lower rates and a prognostic signal in the opposite direction from what immunotherapy enthusiasts might hope. The TIGIT and CD155 finding names a second checkpoint for future trials.
- Caveats: Single German centre; 131 patients.; Scoring systems and clone differ from the Indian study, so the rates are not directly comparable.

## Sources

- Albrecht et al., Cancers 2021: PD-L1 in 131 Western gallbladder cancers: https://doi.org/10.3390/cancers13071682
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33918309/

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/)
- targets: [PD-1](https://onco.cc/targets/pd1/), [PD-L1](https://onco.cc/targets/pdl1/)
- terms: [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/), [Tumour-infiltrating lymphocytes (TILs)](https://onco.cc/terms/tils/)
- journals: [Cancers](https://onco.cc/journals/cancers-mdpi/)
- biomarkers: [PD-L1 CPS (combined positive score)](https://onco.cc/biomarkers/pd-l1-cps/), [PD-L1 TPS (tumour proportion score)](https://onco.cc/biomarkers/pd-l1-tps/)

---
JSON: https://onco.cc/api/v1/entities/paper-albrecht-pdl1-western-gallbladder-cancers-2021.json