PD-L1 is an independent prognostic predictor in gastric cancer of Western patients
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Christine Böger1, Hans-Michael Behrens1, Micaela Mathiak1, Sandra Krüger1, Holger Kalthoff2, Christoph Röcken1
1Department of Pathology, Christian-Albrechts-University, Kiel, Germany
2Department of Experimental Cancer Research, Christian-Albrechts-University, Kiel, Germany
Christoph Röcken, e-mail: firstname.lastname@example.org
Keywords: programmed death-1, predictive biomarker, immune therapy, pembrolizumab
Received: February 03, 2016 Accepted: March 02, 2016 Published: March 18, 2016
Targeting the PD-1/PD-L1 immune checkpoint signaling is a novel promising treatment strategy in several tumor entities, and it is suggested that PD-L1/PD-1 expression is predictive for a PD-1/PD-L1 checkpoint inhibitor treatment response. We investigated the expression of PD-L1 and PD-1 by immunohistochemistry in a large and well characterized gastric cancer (GC) cohort of Caucasian patients, consisting of 465 GC samples and 15 corresponding liver metastases. Staining results were correlated with clinico-pathological characteristics and survival. PD-L1 expression was found in tumor cells of 140 GCs (30.1%) and 9 liver metastases (60%) respectively in immune cells of 411 GCs (88.4%) and 11 liver metastases (73.3%). PD-1 was expressed in tumor infiltrating lymphocytes in 250 GCs (53.8%) and in 11 liver metastases (73.3%). PD-L1 expression was significantly more prevalent in men, GCs of the proximal stomach, unclassified, papillary, Her2/neu-positive, Epstein-Barr-virus-positive, microsatellite instable, and PIK3CA-mutated GCs. A high PD-L1/PD-1 expression was associated with a significantly better patient outcome, and PD-L1 turned out to be an independent survival prognosticator. The correlation of PD-L1/PD-1 expression with distinct clinico-pathological patient characteristics may serve as a surrogate marker of PD-L1-positive GCs and may direct the use of immune checkpoint treatment strategies.
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