Research Papers:

PD-L1 expression in tonsillar cancer is associated with human papillomavirus positivity and improved survival: implications for anti-PD1 clinical trials

Angela M Hong _, Ricardo E Vilain, Sarah Romanes, Jean Yang, Elizabeth Smith, Deanna Jones, Richard A Scolyer, C Soon Lee, Mei Zhang and Barbara Rose

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Oncotarget. 2016; 7:77010-77020. https://doi.org/10.18632/oncotarget.12776

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Angela M Hong1, Ricardo E Vilain2,3, Sarah Romanes4, Jean Yang4, Elizabeth Smith2, Deanna Jones1, Richard A Scolyer1,2, C Soon Lee1,2,5, Mei Zhang1, Barbara Rose1

1Sydney Medical School, The University of Sydney, NSW, Australia

2Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia

3Pathology North (Hunter), John Hunter Hospital, Newcastle, NSW, Australia

4School of Mathematics and Statistics, The University of Sydney, NSW, Australia

5Discipline of Pathology, School of Medicine, Western Sydney University, NSW, Australia

Correspondence to:

Angela M Hong, email: [email protected]

Keywords: tonsillar cancer, oropharyngeal cancer, human papillomavirus, PD-L1, p16

Received: August 15, 2016     Accepted: October 13, 2016     Published: October 20, 2016


In this study, we examined PD-L1 expression by immunohistochemistry in 99 patients with tonsillar cancer and known human papillomavirus (HPV) status to assess its clinical significance. We showed that the pattern of PD-L1 expression is strongly related to HPV status. The PD-L1 positivity rate was 83.3% in HPV-positive cases and 56.9% in HPV-negative cases (p < 0.05). Patients with HPV-positive/PD-L1-positive cancer had significantly better event free survival and overall survival compared with patients with HPV-negative/PD-L1-negative cancer. Relative to those patients with HPV-negative/PD-L1-negative disease who had the highest risk of death, patients with HPV-positive/PD-L1-positive cancers had a 2.85 fold lower risk of developing an event (HR 0.35, 95% CI: 0.16–0.79) and a 4.5 fold lower risk of death (HR =0.22, 95% CI: 0.09–0.53). Our findings will help to guide future clinical trial design in immunotherapy based on PD-L1 expression in tonsillar cancer.

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