PD-L1 and Survival in Solid Tumors: A Meta-Analysis

PLoS One. 2015 Jun 26;10(6):e0131403. doi: 10.1371/journal.pone.0131403. eCollection 2015.

Abstract

Background: Numerous agents targeting PD-L1/PD-1 check-point are in clinical development. However, the correlation between PD-L1 expression and prognosis of solid tumor is still in controversial. Here, we elicit a systematic review and meta-analysis to investigate the potential value of PD-L1 in the prognostic prediction in human solid tumors.

Methods: Electronic databases were searched for studies evaluating the expression of PD-L1 and overall survival (OS) of patients with solid tumors. Odds ratios (ORs) from individual studies were calculated and pooled by using a random-effect model, and heterogeneity and publication bias analyses were also performed.

Results: A total of 3107 patients with solid tumor from 28 published studies were included in the meta-analysis. The median percentage of solid tumors with PD-L1 overexpression was 52.5%. PD-L1 overexpression was associated with worse OS at both 3 years (OR = 2.43, 95% confidence interval (CI) = 1.60 to 3.70, P < 0.0001) and 5 years (OR = 2.23, 95% CI = 1.40 to 3.55, P = 0.0008) of solid tumors. Among the tumor types, PD-L1 was associated with worse 3 year-OS of esophageal cancer, gastric cancer, hepatocellular carcinoma, and urothelial cancer, and 5 year-OS of esophageal cancer, gastric cancer and colorectal cancer.

Conclusions: These results suggest that expression of PD-L1 is associated with worse survival in solid tumors. However, the correlations between PD-L1 and prognosis are variant among different tumor types. More studies are needed to investigate the clinical value of PD-L1 expression in prognostic prediction and treatment option.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • B7-H1 Antigen / biosynthesis*
  • Disease-Free Survival
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Male
  • Neoplasm Proteins / biosynthesis*
  • Neoplasms / metabolism*
  • Neoplasms / mortality*
  • Survival Rate

Substances

  • B7-H1 Antigen
  • CD274 protein, human
  • Neoplasm Proteins

Grant support

This work was supported by grants from the Science and Technology Department of Zhejiang Province (2011c13034~1, to JH and 2013c03044-7, to YC); and Natural Science Foundation of Zhejiang Province (Z2100366, to JH and LY13H160016, to YC).