Serum levels of soluble programmed death ligand 1 predict treatment response and progression free survival in multiple myeloma
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Liang Wang1,2,*, Hua Wang1,2,*, Hao Chen1,3,*, Wei-da Wang1,2, Xiao-qin Chen1,2, Qi-rong Geng1,2, Zhong-jun Xia1,2, Yue Lu1,2
1State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People’s Republic of China
2Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China
3Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China
*These authors have contributed equally to this work
Yue Lu, e-mail: firstname.lastname@example.org
Keywords: multiple myeloma, programmed death-ligand 1, immune checkpoint, prognosis, biomarker
Received: May 31, 2015 Accepted: September 13, 2015 Published: October 16, 2015
Immune checkpoint signaling plays an important role in immunosuppression in multiple myeloma (MM). Blood levels of soluble programmed death-ligand 1 (sPD-L1), a checkpoint-relevant protein, might predict treatment response and survival outcomes in MM patients. We used an enzyme-linked immunosorbent assay to measure serum sPD-L1 levels in 81 newly diagnosed MM patients. We found that myeloma patients had higher sPD-L1 concentrations than healthy controls. The best sPD-L1 cutoff value for predicting disease progression risk was 2.783 ng/mL. The overall response rate to treatment was higher in low sPD-L1 patients than in high sPD-L1 patients. The 3-year progression free survival (PFS) and overall survival (OS) rates for all patients were 16% and 64%, respectively. Multivariate survival analysis including Eastern Cooperative Oncology Group performance status score, treatment response, and sPD-L1 level showed that a less than partial treatment response (PR) and higher sPD-L1 levels (>2.783 ng/ml) were independent prognostic factors for shorter PFS; neither factor was predictive of OS. The serum sPD-L1 level is a valuable biomarker for predicting treatment response and an independent prognostic factor for PFS. PD-1/ PD-L1 blockade may be a promising novel immune-based therapeutic strategy in MM.
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