Prognostic Role of PD-L1 Expression in Renal Cell Carcinoma. A Systematic Review and Meta-Analysis

Roberto Iacovelli, Franco Nolè, Elena Verri, Giuseppe Renne, Chiara Paglino, Matteo Santoni, Maria Cossu Rocca, Palma Giglione, Gaetano Aurilio, Daniela Cullurà, Stefano Cascinu, Camillo Porta

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Several clinical trials have reported that therapies targeting programmed death-1 (PD1) and its ligand (PD-L1) improve patient outcomes, while tumor response has been related to PD-L1 expression.

OBJECTIVE: To investigate the prognostic role of PD-L1 expression in patients affected by renal cell carcinoma (RCC).

METHODS: MEDLINE/PubMed, the Cochrane Library, and ASCO University were searched for studies investigating the prognostic role of PD-L1 expression in RCC. Data extraction was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS: Six studies and 1323 cases were included in the final analysis. PD-L1 was expressed in 24.2 % of clear cell tumors compared to 10.9 % of non-clear cell tumors (p = 0.002). In the overall population, a higher level of PD-L1 expression increased the risk of death by 81 % (HR; 1.81, 95 % CI 1.31-2.49; p < 0.001). When the analysis was restricted to cases evaluated by immunohistochemistry alone, the higher expression of PD-L1 more than doubled the risk of death (HR; 2.05, 95 % CI 1.38-3.05; p < 0.001). In clear cell histology, higher PD-L1 expression increased the risk of death by 53 % (HR; 1.53, 95 % CI 1.27-1.84; p < 0.001), while in metastatic patients, the evaluation of PD-L1 expression on primary tumors revealed that it retains its prognostic role (HR; 1.45, 95 % CI 1.08-1.93; p = 0.01).

LIMITATIONS: Significant heterogeneity has been identified among the included studies. As a consequence, cautious interpretation of the results is recommended.

CONCLUSION: This meta-analysis indicates that a higher level of PD-L1 expression is a negative prognostic factor in RCC. Its validation as an independent prognostic factor compared to other traditionally used clinical parameters in localized or advanced disease is recommended.

Original languageEnglish
Pages (from-to)143-8
Number of pages6
JournalTargeted Oncology
Volume11
Issue number2
DOIs
Publication statusPublished - Apr 2016

Fingerprint

Renal Cell Carcinoma
Meta-Analysis
Neoplasms
PubMed
MEDLINE
Libraries
Histology
Immunohistochemistry
Clinical Trials
Ligands
Population
Therapeutics

Keywords

  • Antigens, CD274
  • Biomarkers, Tumor
  • Carcinoma, Renal Cell
  • Humans
  • Immunohistochemistry
  • Kidney Neoplasms
  • Prognosis
  • Journal Article
  • Meta-Analysis
  • Review

Cite this

Prognostic Role of PD-L1 Expression in Renal Cell Carcinoma. A Systematic Review and Meta-Analysis. / Iacovelli, Roberto; Nolè, Franco; Verri, Elena; Renne, Giuseppe; Paglino, Chiara; Santoni, Matteo; Cossu Rocca, Maria; Giglione, Palma; Aurilio, Gaetano; Cullurà, Daniela; Cascinu, Stefano; Porta, Camillo.

In: Targeted Oncology, Vol. 11, No. 2, 04.2016, p. 143-8.

Research output: Contribution to journalArticle

@article{5ea3e0df5fd044a383ab52e576b922a9,
title = "Prognostic Role of PD-L1 Expression in Renal Cell Carcinoma. A Systematic Review and Meta-Analysis",
abstract = "BACKGROUND: Several clinical trials have reported that therapies targeting programmed death-1 (PD1) and its ligand (PD-L1) improve patient outcomes, while tumor response has been related to PD-L1 expression.OBJECTIVE: To investigate the prognostic role of PD-L1 expression in patients affected by renal cell carcinoma (RCC).METHODS: MEDLINE/PubMed, the Cochrane Library, and ASCO University were searched for studies investigating the prognostic role of PD-L1 expression in RCC. Data extraction was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.RESULTS: Six studies and 1323 cases were included in the final analysis. PD-L1 was expressed in 24.2 {\%} of clear cell tumors compared to 10.9 {\%} of non-clear cell tumors (p = 0.002). In the overall population, a higher level of PD-L1 expression increased the risk of death by 81 {\%} (HR; 1.81, 95 {\%} CI 1.31-2.49; p < 0.001). When the analysis was restricted to cases evaluated by immunohistochemistry alone, the higher expression of PD-L1 more than doubled the risk of death (HR; 2.05, 95 {\%} CI 1.38-3.05; p < 0.001). In clear cell histology, higher PD-L1 expression increased the risk of death by 53 {\%} (HR; 1.53, 95 {\%} CI 1.27-1.84; p < 0.001), while in metastatic patients, the evaluation of PD-L1 expression on primary tumors revealed that it retains its prognostic role (HR; 1.45, 95 {\%} CI 1.08-1.93; p = 0.01).LIMITATIONS: Significant heterogeneity has been identified among the included studies. As a consequence, cautious interpretation of the results is recommended.CONCLUSION: This meta-analysis indicates that a higher level of PD-L1 expression is a negative prognostic factor in RCC. Its validation as an independent prognostic factor compared to other traditionally used clinical parameters in localized or advanced disease is recommended.",
keywords = "Antigens, CD274, Biomarkers, Tumor, Carcinoma, Renal Cell, Humans, Immunohistochemistry, Kidney Neoplasms, Prognosis, Journal Article, Meta-Analysis, Review",
author = "Roberto Iacovelli and Franco Nol{\`e} and Elena Verri and Giuseppe Renne and Chiara Paglino and Matteo Santoni and {Cossu Rocca}, Maria and Palma Giglione and Gaetano Aurilio and Daniela Cullur{\`a} and Stefano Cascinu and Camillo Porta",
year = "2016",
month = "4",
doi = "10.1007/s11523-015-0392-7",
language = "English",
volume = "11",
pages = "143--8",
journal = "Targeted Oncology",
issn = "1776-2596",
publisher = "Springer Paris",
number = "2",

}

TY - JOUR

T1 - Prognostic Role of PD-L1 Expression in Renal Cell Carcinoma. A Systematic Review and Meta-Analysis

AU - Iacovelli, Roberto

AU - Nolè, Franco

AU - Verri, Elena

AU - Renne, Giuseppe

AU - Paglino, Chiara

AU - Santoni, Matteo

AU - Cossu Rocca, Maria

AU - Giglione, Palma

AU - Aurilio, Gaetano

AU - Cullurà, Daniela

AU - Cascinu, Stefano

AU - Porta, Camillo

PY - 2016/4

Y1 - 2016/4

N2 - BACKGROUND: Several clinical trials have reported that therapies targeting programmed death-1 (PD1) and its ligand (PD-L1) improve patient outcomes, while tumor response has been related to PD-L1 expression.OBJECTIVE: To investigate the prognostic role of PD-L1 expression in patients affected by renal cell carcinoma (RCC).METHODS: MEDLINE/PubMed, the Cochrane Library, and ASCO University were searched for studies investigating the prognostic role of PD-L1 expression in RCC. Data extraction was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.RESULTS: Six studies and 1323 cases were included in the final analysis. PD-L1 was expressed in 24.2 % of clear cell tumors compared to 10.9 % of non-clear cell tumors (p = 0.002). In the overall population, a higher level of PD-L1 expression increased the risk of death by 81 % (HR; 1.81, 95 % CI 1.31-2.49; p < 0.001). When the analysis was restricted to cases evaluated by immunohistochemistry alone, the higher expression of PD-L1 more than doubled the risk of death (HR; 2.05, 95 % CI 1.38-3.05; p < 0.001). In clear cell histology, higher PD-L1 expression increased the risk of death by 53 % (HR; 1.53, 95 % CI 1.27-1.84; p < 0.001), while in metastatic patients, the evaluation of PD-L1 expression on primary tumors revealed that it retains its prognostic role (HR; 1.45, 95 % CI 1.08-1.93; p = 0.01).LIMITATIONS: Significant heterogeneity has been identified among the included studies. As a consequence, cautious interpretation of the results is recommended.CONCLUSION: This meta-analysis indicates that a higher level of PD-L1 expression is a negative prognostic factor in RCC. Its validation as an independent prognostic factor compared to other traditionally used clinical parameters in localized or advanced disease is recommended.

AB - BACKGROUND: Several clinical trials have reported that therapies targeting programmed death-1 (PD1) and its ligand (PD-L1) improve patient outcomes, while tumor response has been related to PD-L1 expression.OBJECTIVE: To investigate the prognostic role of PD-L1 expression in patients affected by renal cell carcinoma (RCC).METHODS: MEDLINE/PubMed, the Cochrane Library, and ASCO University were searched for studies investigating the prognostic role of PD-L1 expression in RCC. Data extraction was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.RESULTS: Six studies and 1323 cases were included in the final analysis. PD-L1 was expressed in 24.2 % of clear cell tumors compared to 10.9 % of non-clear cell tumors (p = 0.002). In the overall population, a higher level of PD-L1 expression increased the risk of death by 81 % (HR; 1.81, 95 % CI 1.31-2.49; p < 0.001). When the analysis was restricted to cases evaluated by immunohistochemistry alone, the higher expression of PD-L1 more than doubled the risk of death (HR; 2.05, 95 % CI 1.38-3.05; p < 0.001). In clear cell histology, higher PD-L1 expression increased the risk of death by 53 % (HR; 1.53, 95 % CI 1.27-1.84; p < 0.001), while in metastatic patients, the evaluation of PD-L1 expression on primary tumors revealed that it retains its prognostic role (HR; 1.45, 95 % CI 1.08-1.93; p = 0.01).LIMITATIONS: Significant heterogeneity has been identified among the included studies. As a consequence, cautious interpretation of the results is recommended.CONCLUSION: This meta-analysis indicates that a higher level of PD-L1 expression is a negative prognostic factor in RCC. Its validation as an independent prognostic factor compared to other traditionally used clinical parameters in localized or advanced disease is recommended.

KW - Antigens, CD274

KW - Biomarkers, Tumor

KW - Carcinoma, Renal Cell

KW - Humans

KW - Immunohistochemistry

KW - Kidney Neoplasms

KW - Prognosis

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1007/s11523-015-0392-7

DO - 10.1007/s11523-015-0392-7

M3 - Article

C2 - 26429561

VL - 11

SP - 143

EP - 148

JO - Targeted Oncology

JF - Targeted Oncology

SN - 1776-2596

IS - 2

ER -