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Clinicopathological and prognostic value of PD-L1 in urothelial carcinoma: a meta-analysis

Authors Ding X, Chen Q, Yang Z, Li J, Zhan H, Lu N, Chen M, Yang Y, Wang J, Yang D

Received 12 June 2018

Accepted for publication 7 March 2019

Published 8 May 2019 Volume 2019:11 Pages 4171—4184

DOI https://doi.org/10.2147/CMAR.S176937

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Dr Rituraj Purohit


Xiangli Ding,1 Qiaochao Chen,2 Zhao Yang,3 Jun Li,4 Hui Zhan,1 Nihong Lu,5 Min Chen,6 Yanlong Yang,7 Jiansong Wang,1 Delin Yang1

1Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 2Department of Geriatrics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3Department of Biomedical Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing 100029, China; 4Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 5Department of Respiration, The third people’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China; 6Department of cardiology, The first people’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China; 7Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Kunming, Yunnan, People’s Republic of China

Objective: Our objective was to conduct a meta-analysis to investigate the clinicopathological features and prognostic value of programmed cell death ligand 1 (PD-L1) expression in patients with urothelial carcinoma (UC).
Materials and Methods: Twenty-seven studies with 4,032 patients were included in the meta-analysis. Pooled ORs and 95% CIs were used to examine the associations between clinical factors and PD-L1 expression. HRs and 95% CIs were extracted from eligible studies. Heterogeneity was evaluated using the chi-squared-based Q test and I2, statistic.
Results: Expression of PD-L1 on tumor cells (TCs) was associated with muscle-invasive disease (OR=3.67, 95% CI: 2.53–5.33), and inversely associated with the history of intravesical bacilli Calmette-Guerin therapy (OR=0.39, 95% CI: 0.18–0.82) in bladder cancer patients. PD-L1 expression on TCs was associated with worse overall survival (HR=2.06, 95% CI: 1.38–3.06) in patients with organ-confined bladder cancer. PD-L1 expression in patients with UC was significantly related to better objective response rate after PD-1/PD-L1 antibody treatment.
Conclusions: Expression of PD-L1 on TCs was associated with muscle-invasive disease in patients with bladder cancer. Patients with PD-L1-positive UC had a significantly better response to PD-1/PD-L1 targeted treatment.

Keywords: urothelial carcinoma, programmed cell death ligand 1, immunotherapy, meta-analysis, prognosis

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