The predictive value of PD-L1 expression in response to anti-PD-1/PD-L1 therapy for biliary tract cancer: a systematic review and meta-analysis

被引：8
作者：
Yoon, Seung Bae [1 ]
Woo, Sang Myung [2 ]
Chun, Jung Won [2 ]
Kim, Dong Uk [3 ]
Kim, Jaihwan [4 ]
Park, Joo Kyung [5 ]
So, Hoonsub [6 ]
Chung, Moon Jae [7 ]
Cho, In Rae [8 ]
Heo, Jun [9 ]
机构：
[1] Catholic Univ Korea, Eunpyeong St Marys Hosp, Coll Med, Dept Internal Med, Seoul, South Korea
[2] Natl Canc Ctr, Ctr Liver & Pancreatobiliary Canc, Goyang, South Korea
[3] CHA Univ, Dept Internal Med, Sch Med, Pochon, South Korea
[4] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Coll Med, Seongnam, South Korea
[5] Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Sch Med, Seoul, South Korea
[6] Univ Ulsan, Ulsan Univ Hosp, Dept Internal Med, Coll Med, Ulsan, South Korea
[7] Yonsei Univ, Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea
[8] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Internal Med, Coll Med, Seoul, South Korea
[9] Kyungpook Natl Univ, Dept Internal Med, Sch Med, Daegu, South Korea
来源：
FRONTIERS IN IMMUNOLOGY | 2024年 / 15卷
关键词：
cholangiocarcinoma; programmed death ligand 1; immune checkpoint inhibitors; biomarker; immunohistochemistry; OPEN-LABEL; NIVOLUMAB; GEMCITABINE; SAFETY; PEMBROLIZUMAB; LENVATINIB; CISPLATIN; SURVIVAL; EFFICACY;
D O I：
10.3389/fimmu.2024.1321813
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background: Recently, anti-programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) immunotherapy offers promising results for advanced biliary tract cancer (BTC). However, patients show highly heterogeneous responses to treatment, and predictive biomarkers are lacking. We performed a systematic review and meta-analysis to assess the potential of PD-L1 expression as a biomarker for treatment response and survival in patients with BTC undergoing anti-PD-1/PD-L1 therapy. Methods: We conducted a comprehensive systematic literature search through June 2023, utilizing the PubMed, EMBASE, and Cochrane Library databases. The outcomes of interest included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) according to PD-L1 expression. Subgroup analyses and meta-regression were performed to identify possible sources of heterogeneity. Results: A total of 30 studies was included in the final analysis. Pooled analysis showed no significant differences in ORR (odds ratio [OR], 1.56; 95% confidence intervals [CIs], 0.94-2.56) and DCR (OR, 1.84; 95% CIs, 0.88-3.82) between PD-L1 (+) and PD-L1 (-) patients. In contrast, survival analysis showed improved PFS (hazard ratio [HR], 0.54, 95% CIs, 0.41-0.71) and OS (HR, 0.58; 95% CI, 0.47-0.72) among PD-L1 (+) patients compared to PD-L1 (-) patients. Sensitivity analysis excluding retrospective studies showed no significant differences with the primary results. Furthermore, meta-regression demonstrated that drug target (PD-1 vs. PD-L1), presence of additional intervention (monotherapy vs. combination therapy), and PD-L1 cut-off level (1% vs. >= 5%) significantly affected the predictive value of PD-L1 expression. Conclusion: PD-L1 expression might be a helpful biomarker for predicting PFS and OS in patients with BTC undergoing anti-PD-1/PD-L1 therapy. The predictive value of PD-L1 expression can be significantly influenced by diagnostic or treatment variables.
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页数：13
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