The clinical significance of PD-L1 in advanced gastric cancer is dependent onARID1Amutations and ATM expression

ARID1A型 癌症 癌症研究 医学 免疫染色 PD-L1 肿瘤科 临床意义 内科学 免疫组织化学 突变 生物 基因 免疫疗法 遗传学
作者
Simonetta Buglioni,Elisa Melucci,Francesca Sperati,Matteo Pallocca,Irene Terrenato,Francesca De Nicola,Frauke Goeman,Beatrice Casini,Carla Azzurra Amoreo,Enzo Gallo,Maria Grazia Diodoro,Edoardo Pescarmona,Patrizia Vici,Domenico Sergi,Laura Pizzuti,Luigi Di Lauro,Marco Mazzotta,Maddalena Barba,Maurizio Fanciulli,Ilio Vitale,Ruggero De Maria,Gennaro Ciliberto,Marcello Maugeri‐Saccà
出处
期刊:OncoImmunology [Landes Bioscience]
卷期号:: e1457602-e1457602 被引量:20
标识
DOI:10.1080/2162402x.2018.1457602
摘要

Whether PD-L1 expression is associated with survival outcomes in gastric cancer (GC) is controversial. The inhibition of the PD-1/PD-L1 pathway is effective against genomically unstable tumors. Hypothesizing that also the clinical significance of PD-L1 might be dependent on the activation of molecular circuits ensuring genomic stability, we evaluated PD-L1 expression in tissue samples from 72 advanced GC patients treated with first-line chemotherapy. Samples were already characterized for DNA damage repair (DDR) component expression (pATM, pChk1, pWee1, γ-H2AX and pRPA2) along with mutations in DDR-linked genes (TP53 and ARID1A). Overall, PD-L1 expression was not associated with progression-free survival (PFS) and overall survival (OS), independently on whether we considered its expression in tumor cells (PD-L1-TCs) or in the immune infiltrate (PD-L1-TILs). In subgroup analysis, positive PD-L1-TC immunostaining was associated with better PFS in patients whose tumors did not carry DDR activation (multivariate Cox: HR 0.34, 95%CI: 0.15–0.76, p = 0.008). This subset (DDRoff) was characterized by negative pATM expression or the presence of ARID1A mutations. Conversely, the relationship between PD-L1-TC expression and PFS was lost in a molecular scenario denoting DDR activation (DDRon), as defined by concomitant pATM expression and ARID1A wild-type form. Surprisingly, while PD-L1-TC expression was associated with better OS in the DDRoff subset (multivariate Cox: HR 0.41, 95% CI: 0.17–0.96, p = 0.039), in the DDRon subgroup we observed an opposite impact on OS (multivariate Cox: HR 2.56, 95%CI: 1.06–6.16, p = 0.036). Thus, PD-L1-TC expression may impact survival outcomes in GC on the basis of the activation/inactivation of genome-safeguarding pathways.
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