Clinical relevance of PD-L1 expression in gallbladder cancer: a potential target for therapy
In 174 Indian gallbladder cancers, about a quarter had PD-L1 on tumour cells and a quarter on immune cells, more so in higher-grade tumours, but PD-L1 did not predict survival.
Overview
174 cases of gallbladder carcinoma were evaluated for PD-L1 expression with the SP263 clone on tissue microarrays, at cut-offs of 1%, 10% and 50% in tumour cells and in tumour-infiltrating lymphocytes, and correlated with clinicopathological characteristics and survival. Mean age was 49.9 years, the male to female ratio 1 to 2.9, and 73.6% presented with stage 3 or 4 disease.
Tumour cells expressed PD-L1 in 23.0% of cases and tumour-infiltrating lymphocytes in 24.1%; at cut-offs of 10% and 50%, 14.9% and 7.5% of cases were positive. Tumour proportion score was associated with histological type, histological and nuclear grade, nodal metastasis, higher stage and tumour-infiltrating lymphocytes. Paired lymph node metastases showed discordantly higher PD-L1 than primaries. Overall survival was not associated with PD-L1 expression (P = 0.546).
- PD-L1 on tumour cells in 23.0% at 1%, 14.9% at 10% and 7.5% at 50%; on immune cells in 24.1% (SP263).
- Associated with histological type and grade, nuclear grade and nodal metastasis; higher in nodal metastases than primaries.
- No association with overall survival (P = 0.546).
The largest PD-L1 series from a high-incidence country; the one-in-four figure is the number quoted for gallbladder cancer, though the Western series with a different clone found fewer. No biliary approval uses PD-L1 to select patients.
- Tissue microarrays sample a small core of heterogeneous tumours.
- SP263 clone and tumour-cell scoring are not interchangeable with 22C3 CPS.
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