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Tumour cell PD-L1 expression is prognostic in patients with malignant pleural effusion: the impact of C-reactive protein and immune-checkpoint inhibition.
- Source :
-
Scientific reports [Sci Rep] 2020 Apr 01; Vol. 10 (1), pp. 5784. Date of Electronic Publication: 2020 Apr 01. - Publication Year :
- 2020
-
Abstract
- Malignant pleural effusion (MPE) confers dismal prognosis and has limited treatment options. While immune-checkpoint inhibition (ICI) proved clinical efficacy in a variety of malignancies, data on the prognostic role of PD-L1 in MPE is scarce. We retrospectively studied PD-L1 tumour proportion score and Ki-67 index in pleural biopsies or cytologies from 123 patients (69 lung cancer, 25 mesothelioma, and 29 extrathoracic primary malignancies). Additionally, the impact of C-reactive protein (CRP) and platelet count was also analysed. Median overall survival (OS) after MPE diagnosis was 9 months. Patients with PD-L1 positive tumours (≥1%) had significantly shorter OS than patients with negative PD-L1 status (p = 0.031). CRP and Ki-67 index were also prognostic and remained independent prognosticators after multivariate analysis. Interestingly, Ki-67 index and CRP influenced the prognostic power of PD-L1. Finally, patients receiving ICI tended to have a longer median OS and CRP - but not PD-L1 - was a significant prognosticator in this subgroup. In summary, histological and circulating biomarkers should also be taken into account as potential biomarkers in ICI therapy and they may have an impact on the prognostic power of PD-L1. Our findings might help personalizing immune-checkpoint inhibition for patients with MPE and warrant further prospective validation.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological therapeutic use
Female
Humans
Immunotherapy
Lung Neoplasms blood
Lung Neoplasms therapy
Male
Mesothelioma, Malignant blood
Mesothelioma, Malignant therapy
Middle Aged
Pleural Effusion, Malignant blood
Pleural Effusion, Malignant therapy
Prognosis
Retrospective Studies
B7-H1 Antigen analysis
C-Reactive Protein analysis
Lung Neoplasms diagnosis
Mesothelioma, Malignant diagnosis
Pleural Effusion, Malignant diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 32238865
- Full Text :
- https://doi.org/10.1038/s41598-020-62813-2