Back to Search Start Over

Expression of PD-1 and CTLA-4 Are Negative Prognostic Markers in Renal Cell Carcinoma

Authors :
Erlmeier, Andreas Kahlmeyer
Christine Stöhr
Arndt Hartmann
Peter Goebell
Bernd Wullich
Sven Wach
Helge Taubert
Franziska
Source :
Journal of Clinical Medicine; Volume 8; Issue 5; Pages: 743
Publication Year :
2019
Publisher :
Multidisciplinary Digital Publishing Institute, 2019.

Abstract

Immuno-oncological therapy with checkpoint inhibition (CI) has become a new standard treatment in metastatic renal cell carcinoma (RCC), but the prognostic value of the expression of CI therapy target molecules is still controversial. 342 unselected consecutive RCC tumor samples were analyzed regarding their PD-1, PD-L1, and CTLA-4 expression by immunohistochemistry (IHC). The prognostic values for cancer-specific survival (CSS) and overall survival (OS) were analyzed for those not exposed to CI therapy. The expression of PD-1 in tumor-infiltrating mononuclear cells (TIMC) and PD-L1 in tumor cells was detected in 9.4% and 12.3%, respectively (Immune reactive score (IRS) > 0). Furthermore, PD-L1 expression in TIMC (IRS > 0) and CTLA-4 expression in TIMC (>1% positive cells) was detected in 4.8% and 6.3%. PD-1 expression and CTLA-4 expression were significantly associated with a worse OS and CSS in log rank survival analysis and univariate Cox regression analysis. CTLA-4 expression is a prognostic marker that is independently associated with a worse outcome in multivariate Cox regression analysis in the whole cohort (OS: p = 0.013; CSS: p = 0.048) as well as in a non-metastatic subgroup analysis (OS: p = 0.028; CSS: p = 0.022). Patients with combined CTLA-4 expression and PD-1-expression are at highest risk in OS and CSS. In RCC patients, PD-1 expression in TIMC and CTLA-4 expression in TIMC are associated with a worse OS and CSS. The combination of PD-1 expression in TIMC and CTLA-4 expression in TIMC might identify high risk patients. This is, to our knowledge, the first description of CTLA-4 expression to be a prognostic marker in RCC.

Details

Language :
English
ISSN :
20770383
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine; Volume 8; Issue 5; Pages: 743
Accession number :
edsair.multidiscipl..23832a9ecaa3bacbf5e2b5aa219cfde3
Full Text :
https://doi.org/10.3390/jcm8050743