Pablo Azcue1, Ignacio Encío1,2, David Guerrero Setas3,4,5,6, Javier Suarez Alecha7, Arkaitz Galbete2,4,8, María Mercado3, Ruth Vera2,6, Maria Luisa Gomez-Dorronsoro2,3. 1. Department of Health Science, Public University of Navarra (UPNA), 31008 Pamplona, Spain. 2. Institute for Health Research Navarra (IdISNA), 31008 Pamplona, Spain. 3. Department of Molecular Pathology, Hospital Complex of Navarra (CHN), 31008 Pamplona, Spain. 4. Campus Arrosadia, Public University of Navarra (UPNA), 31006 Pamplona, Spain. 5. Molecular Pathology of Cancer Group-Navarrabiomed, 31008 Pamplona, Spain. 6. Department of Medical Oncology, Hospital Complex of Navarra (CHN), 31008 Pamplona, Spain. 7. Department of Surgery, Hospital Complex of Navarra (CHN), 31008 Pamplona, Spain. 8. Navarrabiomed-Hospital Complex of Navarra (CHN), Redissec, 31008 Pamplona, Spain.
Abstract
BACKGROUND: There is a patent need to better characterize early-stage colorectal cancer (CRC) patients. PD-1 ligand (PD-L1) expression has been proposed as a prognostic factor but yields mixed results in different settings. The Consensus Molecular Subtype (CMS) classification has yet to be integrated into clinical practice. We sought to evaluate the prognostic value of PD-L1 expression overall and within CMS in early-stage colon cancer patients, in the hope of assisting treatment choice in this setting. METHODS: Tissue-microarrays were constructed from tumor samples of 162 stage II/III CRC patients. They underwent automatic immunohistochemical staining for PD-L1 and the proposed CMS panel. Primary endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS: PD-L1 expression was significantly and independently associated with better prognosis (HR = 0.46 (0.26-0.82), p = 0.009) and was mostly seen in immune cells of the tumor-related stroma. CMS4 five-folds the risk of mortalitycompared with CMS1 (HR = 5.58 (1.36, 22.0), p = 0.034). In the subgroup CMS2/CMS3 analysis, PD-L1 expression significantly differentiated individuals with better OS (p = 0.004) and DFS (p < 0.001). CONCLUSIONS: Our study suggests that PD-L1 expression is an independent prognostic factor in patients with stage II/III colon cancer. Additionally, it successfully differentiates patients with better prognosis in the CMS2/CMS3 group and may prove significant for the clinical relevance of the CMS classification.
BACKGROUND: There is a patent need to better characterize early-stage colorectal cancer (CRC) patients. PD-1 ligand (PD-L1) expression has been proposed as a prognostic factor but yields mixed results in different settings. The Consensus Molecular Subtype (CMS) classification has yet to be integrated into clinical practice. We sought to evaluate the prognostic value of PD-L1 expression overall and within CMS in early-stage colon cancerpatients, in the hope of assisting treatment choice in this setting. METHODS: Tissue-microarrays were constructed from tumor samples of 162 stage II/III CRCpatients. They underwent automatic immunohistochemical staining for PD-L1 and the proposed CMS panel. Primary endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS:PD-L1 expression was significantly and independently associated with better prognosis (HR = 0.46 (0.26-0.82), p = 0.009) and was mostly seen in immune cells of the tumor-related stroma. CMS4 five-folds the risk of mortalitycompared with CMS1 (HR = 5.58 (1.36, 22.0), p = 0.034). In the subgroup CMS2/CMS3 analysis, PD-L1 expression significantly differentiated individuals with better OS (p = 0.004) and DFS (p < 0.001). CONCLUSIONS: Our study suggests that PD-L1 expression is an independent prognostic factor in patients with stage II/III colon cancer. Additionally, it successfully differentiates patients with better prognosis in the CMS2/CMS3 group and may prove significant for the clinical relevance of the CMS classification.
Authors: Antonio J Ruiz-Rodríguez; Maria P Molina-Vallejo; Inés Aznar-Peralta; Cristina González Puga; Inés Cañas García; Encarna González; Jose A Lorente; M Jose Serrano; M Carmen Garrido-Navas Journal: Cancers (Basel) Date: 2021-12-20 Impact factor: 6.639