Prognostic value of PD-L1 in esophageal squamous cell carcinoma: a meta-analysis
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Wei Guo1, Pan Wang1, Ning Li1, Fei Shao1, Hao Zhang1, Zhenlin Yang1, Renda Li1, Yibo Gao1 and Jie He1
1Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10021, The People’s Republic of China
Jie He, email: [email protected]
Yibo Gao, email: [email protected]
Keywords: esophageal squamous cell carcinoma; prognostic value; programmed death receptor 1; programmed death receptor 1 ligand 1; meta-analysis
Received: August 15, 2017 Accepted: November 20, 2017 Published: December 27, 2017
Accumulated evidence has shown that the programmed cell death receptor 1/programmed cell death receptor 1 ligand 1 (PD-1/PD-L1) pathway is a promising therapeutic target for cancer immunotherapy. However, the association between PD-L1 and esophageal squamous cell carcinoma (ESCC) patient survival remains unclear. We performed a meta-analysis to investigate the prognostic value of PD-L1 in ESCC. We searched PubMed, Embase, Web of Knowledge, and Cochrane Central Register of Controlled Trials databases for relevant studies that evaluated PD-L1 expression and ESCC patient survival. Fixed- and random-effects meta-analyses were conducted according to the heterogeneity of the included studies. Sensitivity analysis was performed according to Metan-based influence analysis. Publication bias was evaluated using Egger’s and Begg’s tests. Overall, 13 studies with 2,877 patients were included. Twelve studies demonstrated the association between overall survival (OS), and 6 studies described the relation between disease-free survival (DFS). PD-L1 overexpression was found in 43.7% (1,258 of 2,877) of the patients with ESCC. High PD-L1 expression was associated with distant metastasis in patients with ESCC (P = 0.04). Moreover, high PD-L1 expression was significantly associated with poor OS (hazard ratio [HR] 1.38, 95% confidence interval [CI] = 1.02–1.86, P = 0.04) and especially in Asian populations (HR 1.49, 95% CI = 1.11–1.99, P = 0.008). But it did not have an impact on disease-free survival (HR 1.15, 95% CI = 0.76–1.74, P = 0.52). Further well-designed clinical studies with uniform assessment approaches for PD-L1 expression are warranted to verify its prognostic value.
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