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Tumor cell PD-L1 predicts poor local control for rectal cancer patients following neoadjuvant radiotherapy

Authors Shao LD, Peng QQ, Du KX, He JY, Dong YP, Lin XY, Li JL, Wu JX

Received 18 April 2017

Accepted for publication 12 June 2017

Published 29 June 2017 Volume 2017:9 Pages 249—258


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Kenan Onel

Lingdong Shao,* Qingqin Peng,* Kaixin Du,* Junyan He, Yaping Dong, Xiaoyi Lin, Jinluan Li, Junxin Wu

Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China

*These authors contributed equally to this work

Abstract: The tumor cell (TC) PD-L1 expression has been reported by several studies in various types of cancer, and it reduces the cytotoxicity of T-cells toward cancer and evades the anticancer immune response. Herein, our study focuses on the impact of PD-L1 expression in prognosis and the correlation with clinical prognostic factors for local advanced rectal cancer with neoadjuvant radiotherapy (RT). A total of 68 rectal cancer patients treated with neoadjuvant RT were retrospectively enrolled in the present study. PD-L1 expression was investigated using immunohistochemistry. A regression model was used to identify prognostic factors associated with the disease-free survival, the local recurrence-free survival (LRFS), and the overall survival rates. The median follow-up was 32.5 months. Seven patients presented TC PD-L1 positive (TC PD-L1+), while the others were TC PD-L1 negative (TC PD-L1–). TC PD-L1+ patients showed frequent tumor recurrence than TC PD-L1– patients. Several patients with TC PD-L1– underwent long-course RT. TC PD-L1 expression was similar to interstitial cell (IC) PD-L1 expression, and the relationship between IC PD-L1 and pathological T stage was observed. TC PD-L1+ was related to poor LRFS. The multivariate analysis showed TC PD-L1+ as an independent negative prognostic factor for LRFS. In conclusion, TC PD-L1 expression putatively predicts the LRFS for patients with rectal cancer following neoadjuvant RT. The patients with TC PD-L1+ are susceptible to high local recurrent rate, thereby proposing a novel immunotherapeutic strategy for PD-L1 inhibition-mediated control.

Keywords: PD-L1, rectal cancer, neoadjuvant radiotherapy, prognosis

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