Prognostic value of programmed cell death ligand 1 expression in patients with intrahepatic cholangiocarcinoma: a meta-analysis

Abstract

BackgroundProgrammed cell death ligand 1 (PD-L1) is highly expressed in intrahepatic cholangiocarcinoma (ICC) tissues. But there is still a dispute over the prognostic value of PD-L1 in patients with ICC. This study aimed to evaluate the prognostic value of PD-L1 expression in patients with ICC.MethodsWe performed a meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. We searched the literature from PubMed, Embase, Web of Science, and the Cochrane Library up to December 5, 2022. Hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated to analyze the overall survival (OS), recurrence-free survival (RFS), and time to relapse. The quality of the studies was assessed using the Newcastle-Ottawa scale. Publication bias was assessed using a funnel plot and Egger’s test.ResultsTen trials with 1944 cases were included in this meta-analysis. The results showed that the low-PD-L1 group had a statistically significant advantage in OS (HR, 1.57; 95% CI, 1.38–1.79, P <0.00001), RFS (HR, 1.62; 95% CI, 1.34–1.97, P <0.00001), and time to relapse (HR, 1.60; 95% CI, 1.25–2.05, P = 0.0002) compared with the high-PD-L1 group. High programmed cell death (PD1)levels, on the other hand, were correlated with poorer OS (HR, 1.96; 95% CI, 1.43–2.70; P <0.0001) and RFS (HR, 1.87; 95% CI, 1.21–2.91; P = 0.005). Multivariate analysis showed that PD-L1 could act as an independent predictor for OS (HR, 1.48; 95% CI, 1.14–1.91; P = 0.003) and RFS (HR, 1.74; 95% CI, 1.22–2.47; P = 0.002), and PD1 acted as an independent predictor for OS (HR, 1.66; 95% CI, 1.15–2.38; P = 0.006).ConclusionThis meta-analysis demonstrated that high PD-L1/PD1 expression is associated with poor survival in ICC. PD-L1/PD1 may be a valuable prognostic and predictive biomarker and potential therapeutic target in ICC.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022380093.

Tumor immune microenvironment and the current immunotherapy of cholangiocarcinoma (Review)

“…An elevated expression of PD-L1 has been linked to tumor progression and a poorer prognosis. CCA tumors with a high PD-L1 expression tend to display more aggressive features and shorter survival times ( 124 , 125 ). CTLA-4 has also been observed to be upregulated in CCA, and of note, a significant positive correlation exists between the expression levels of PD-1 and CTLA-4 ( 126 ).…”

Clinical outcomes of immune checkpoint inhibitor combined with other targeted or immunological therapy regimens for the treatment of advanced bile tract cancer: a systematic review and meta-analysis

“…By inhibiting immunological checkpoint molecules, such as programmed cell death protein 1 (PD1), programmed cell death ligand 1 (PDL1), and cytotoxic T lymphocyte antigen 4 (CTLA-4), ICI enables T-cell-mediated tumor cell killing and the elimination of regulatory T cells (Treg) ( 11 , 12 ). Increased expression levels of PD1 and PDL1 have been detected in BTC tissue compared to non-tumor tissue, suggesting the use of anti-PD1/PDL1 might be effective in BTC ( 13 ). However, the objective response rate (ORR) to anti-PD-1 monotherapy was shown to be limited in early-phase studies ( 14 , 15 ), ranging from 5.8%–22%.…”