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BMC Urology
Published in: BMC Urology 1/2024

Open Access 01-12-2024 | Urothelial Cancer | Research

PD-L1 expression in tumor and inflammatory cells is associated with favorable tumor features and favorable prognosis in muscle-invasive urothelial carcinoma of the bladder not treated by immune checkpoint inhibitors

Authors: Henning Plage, Kira Furlano, Sebastian Hofbauer, Sarah Weinberger, Bernhard Ralla, Antonia Franz, Annika Fendler, Michela de Martino, Florian Roßner, Sefer Elezkurtaj, Martina Kluth, Maximilian Lennartz, Niclas C. Blessin, Andreas H. Marx, Henrik Samtleben, Margit Fisch, Michael Rink, Marcin Slojewski, Krystian Kaczmarek, Thorsten Ecke, Steffen Hallmann, Stefan Koch, Nico Adamini, Henrik Zecha, Sarah Minner, Ronald Simon, Guido Sauter, Joachim Weischenfeldt, Tobias Klatte, Thorsten Schlomm, David Horst, Simon Schallenberg

Published in: BMC Urology | Issue 1/2024

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Abstract

Background

A high level of PD-L1 expression is the most relevant predictive parameter for response to immune checkpoint inhibitor (CPI) therapy in urinary bladder cancer. Existing data on the relationship between PD-L1 expression and the natural course of disease are controversial and sparse.

Methods

To expand our understanding of the relationship between PD-L1 expression and parameters of cancer aggressiveness, PD-L1 was analyzed on tissue microarrays containing 2710 urothelial bladder carcinomas including 512 patients with follow-up data who underwent radical cystectomy and follow-up therapies in the pre-immune checkpoint inhibitor therapy era.

Results

Tumor cell positivity in ≥10% of cells were seen in 513 (20%) and an immune cell positivity occurred in 872 (34%) of 2566 interpretable cancers. PD-L1 positivity in tumor cells increased from pTaG2 low grade (0.9% positive) to pTaG3 high grade (4.1%; p = 0.0255) and was even higher in muscle-invasive (pT2–4) carcinomas (29.3%; p < 0.0001). However, within pT2–4 carcinomas, PD-L1 positivity was linked to low pT stage (p = 0.0028), pN0 (p < 0.0001), L0 status (p = 0.0005), and a better prognosis within 512 patients with cystectomy who never received CPIs (p = 0.0073 for tumor cells and p = 0.0086 for inflammatory cells). PD-L1 staining in inflammatory cells was significantly linked to PD-L1 staining in tumor cells (p < 0.0001) and both were linked to a positive p53 immunostaining (p < 0.0001).

Conclusion

It cannot be fully excluded that the strong statistical link between PD-L1 status and favorable histological tumor features as well as better prognosis could influence the outcome of studies evaluating CPIs in muscle-invasive urothelial carcinoma.
Appendix
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Metadata
Title
PD-L1 expression in tumor and inflammatory cells is associated with favorable tumor features and favorable prognosis in muscle-invasive urothelial carcinoma of the bladder not treated by immune checkpoint inhibitors
Authors
Henning Plage
Kira Furlano
Sebastian Hofbauer
Sarah Weinberger
Bernhard Ralla
Antonia Franz
Annika Fendler
Michela de Martino
Florian Roßner
Sefer Elezkurtaj
Martina Kluth
Maximilian Lennartz
Niclas C. Blessin
Andreas H. Marx
Henrik Samtleben
Margit Fisch
Michael Rink
Marcin Slojewski
Krystian Kaczmarek
Thorsten Ecke
Steffen Hallmann
Stefan Koch
Nico Adamini
Henrik Zecha
Sarah Minner
Ronald Simon
Guido Sauter
Joachim Weischenfeldt
Tobias Klatte
Thorsten Schlomm
David Horst
Simon Schallenberg
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2024
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-024-01482-z

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