Prognostic and predictive values of PD-L1 expression in patients with digestive system cancer: a meta-analysis
Received 27 March 2017
Accepted for publication 17 June 2017
Published 21 July 2017 Volume 2017:10 Pages 3625—3634
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 3
Editor who approved publication: Dr Samir Farghaly
Cong Dai,1,* Meng Wang,1,* Jun Lu,2,* Zhiming Dai,3 Shuai Lin,1 Pengtao Yang,1 Tian Tian,1 Xinghan Liu,1 Weili Min,1 Zhijun Dai1
1Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, 2Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, 3Department of Anesthesia, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
*These authors contributed equally to this work
Background: PD-L1 has been reported to be expressed in diverse human malignancies. However, the prognostic value of PD-L1 in digestive system cancers remains inconclusive. Therefore, we conducted this meta-analysis to evaluate the prognostic impact of PD-L1 expression in digestive system cancers.
Materials and methods: We searched the PubMed, Embase, and the Chinese National Knowledge Infrastructure for publications concerning PD-L1 expression in digestive system cancers. Correlations of PD-L1 expression level with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were analyzed.
Results: Finally, 32 studies with 7,308 patients were included. Our results show that PD-L1 expression was significantly associated with poorer OS (hazard ratio [HR] =1.44, 95% confidence interval [CI] =1.18–1.76, P<0.001), but not DFS (HR =0.91, 95% CI =0.61–1.37, P=0.657) or RFS (HR =1.27, 95% CI =0.75–2.14, P=0.368). Moreover, in the subgroup analysis, significant associations between PD-L1 expression and OS were found in Asians (HR =1.50, 95% CI =1.19–1.89, P=0.001), gastric cancer (HR =1.43, 95% CI =1.05–1.94, P=0.021), and pancreatic carcinoma (HR =2.64, 95% CI =1.78–3.93, P<0.001).
Conclusion: These results suggest that the expression of PD-L1 is associated with worse OS in digestive system cancers, especially in gastric cancer and pancreatic cancer. In addition, PD-L1 may act as a new parameter for predicting poor prognosis and a promising target for anticancer therapy in digestive system cancers.
Keywords: PD-L1, digestive system cancers, prognosis, meta-analysis
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