Marra Aghajani1,2, Susannah Graham1,2,3, Charles McCafferty2, Christina Abdel Shaheed4, Tara Roberts1,2,5, Paul DeSouza1,2,5, Tao Yang2,6,7, Navin Niles1,2,3. 1. 1 Department of Medical Oncology, Ingham Institute for Applied Medical Research , Liverpool, Australia . 2. 2 School of Medicine, Western Sydney University , Campbelltown, Australia . 3. 3 Department of Head and Neck Surgery, Liverpool Hospital , Liverpool, Australia . 4. 4 Sydney School of Public Health, University of Sydney , Sydney, Australia . 5. 5 South West Sydney Clinical School , UNSW Sydney, Sydney, Australia . 6. 6 Saint Vincent's Clinical School , UNSW Sydney, Sydney, Australia . 7. 7 SydPath, Saint Vincent's Hospital , Sydney, Australia .
Abstract
BACKGROUND: Evidence has shown that programmed cell death ligand 1 (PD-L1) overexpression is associated with poor prognosis and resistance to immune therapies in several human cancers. However, data on the prognostic significance of PD-L1 expression in thyroid cancer are limited and remain controversial. This systematic review and meta-analysis aimed to evaluate comprehensively the clinicopathologic significance and prognostic value of PD-L1 expression in non-medullary thyroid cancers. METHODS: Electronic databases, including Medline/PubMed, EMBASE, and the Cochrane Library, were searched up until July 5, 2017. In total, seven comparisons (from six articles) comprising 1421 patients were included in the pooled analysis. RESULTS: There was moderate quality evidence from four studies (n = 721) that shows positive PD-L1 expression was significantly associated with poor survival among thyroid cancer patients (pooled hazard ratio = 3.73 [confidence interval (CI) 2.75-5.06]). Increased PD-L1 expression was also found to be significantly associated with disease recurrence (odds ratio = 1.95 [CI 1.15-3.32]) and concurrent thyroiditis (odds ratio = 1.65 [CI 1.09-2.51]). CONCLUSIONS: The results confirm the prognostic significance of PD-L1 expression in thyroid cancer patients. PD-L1 expression has the potential to be implemented as a prognostic biomarker used to guide clinicians in identifying patients with more aggressive cancers, and for the selection of individuals that would derive durable clinical benefit from anti-PD-1/PD-L1 immunotherapy. Prospective clinical trials will be useful to support these findings.
BACKGROUND: Evidence has shown that programmed cell death ligand 1 (PD-L1) overexpression is associated with poor prognosis and resistance to immune therapies in several humancancers. However, data on the prognostic significance of PD-L1 expression in thyroid cancer are limited and remain controversial. This systematic review and meta-analysis aimed to evaluate comprehensively the clinicopathologic significance and prognostic value of PD-L1 expression in non-medullary thyroid cancers. METHODS: Electronic databases, including Medline/PubMed, EMBASE, and the Cochrane Library, were searched up until July 5, 2017. In total, seven comparisons (from six articles) comprising 1421 patients were included in the pooled analysis. RESULTS: There was moderate quality evidence from four studies (n = 721) that shows positive PD-L1 expression was significantly associated with poor survival among thyroid cancerpatients (pooled hazard ratio = 3.73 [confidence interval (CI) 2.75-5.06]). Increased PD-L1 expression was also found to be significantly associated with disease recurrence (odds ratio = 1.95 [CI 1.15-3.32]) and concurrent thyroiditis (odds ratio = 1.65 [CI 1.09-2.51]). CONCLUSIONS: The results confirm the prognostic significance of PD-L1 expression in thyroid cancerpatients. PD-L1 expression has the potential to be implemented as a prognostic biomarker used to guide clinicians in identifying patients with more aggressive cancers, and for the selection of individuals that would derive durable clinical benefit from anti-PD-1/PD-L1 immunotherapy. Prospective clinical trials will be useful to support these findings.
Entities:
Keywords:
meta-analysis; prognostic significance; programmed cell death ligand 1; survival; thyroid cancer