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Prognostic value of PD-L1 overexpression for pancreatic cancer: evidence from a meta-analysis

Authors Zhuan-Sun Y, Huang F, Feng M, Zhao X, Chen W, Zhu Z, Zhang S

Received 15 July 2017

Accepted for publication 20 September 2017

Published 16 October 2017 Volume 2017:10 Pages 5005—5012

DOI https://doi.org/10.2147/OTT.S146383

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr Tohru Yamada

Yongxun Zhuan-Sun,1,2,* Fengting Huang,2,3,* Min Feng,4 Xinbao Zhao,5 Wenying Chen,3 Zhe Zhu,6 Shineng Zhang2,3

1Department of Respirology, 2Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, 3Department of Gastroenterology, 4Department of Nephrology, 5Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China; 6Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, USA

*These authors contributed equally to this work

Abstract: Programmed death-ligand 1 (PD-L1) is an immune checkpoint that is often activated in cancer and plays a pivotal role in the initiation and progression of cancer. However, the clinicopathologic significance and prognostic value of PD-L1 in pancreatic cancer (PC) remains controversial. In this study, we conducted a meta-analysis to retrospectively evaluate the relationship between PD-L1 and PC. PubMed and other databases were searched for the clinical studies published up to March 21, 2017, to be included in the meta-analysis. Hazard ratios and their 95% CIs were calculated. Risk ratios (RRs) were extracted to assess the correlations between the clinicopathologic parameters and PD-L1 expression. Ten studies including 1,058 patients were included in the meta-analysis. The pooled results indicated that positive PD-L1 expression was correlated with a poor overall survival outcome in PC patients (hazard ratio =1.76, 95% CI: 1.43–2.17, P<0.00001). Interestingly, high PD-L1 expression was correlated with poor pathologic differentiation (RR =1.57, 95% CI: 1.25–1.98, P=0.0001) and neural invasion (RR =1.30, 95% CI: 1.03–1.64, P=0.03). However, there were no significant correlations between PD-L1 expression and other clinicopathologic characteristics. In summary, our meta-analysis implied that PD-L1 could serve as a negative predictor for the overall survival of PC patients, and high expression of PD-L1 was correlated with poor differentiation and neural invasion, indicating that anti-PD-L1 treatments should be evaluated in PC patients, especially in those who exhibit these two characteristics.

Keywords: pancreatic cancer, programmed death-ligand 1, prognosis, clinicopathologic characteristics, meta-analysis, immune checkpoint

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