PD-L1 expression in microvascular endothelial cells predicts the efficacy and side effects of anlotinib

Front Oncol. 2025 Jul 30:15:1544278. doi: 10.3389/fonc.2025.1544278. eCollection 2025.

Abstract

Background: Immunotherapy plays a crucial role in the treatment of tumors. However, few studies have investigated the relationship between the expression of Programmed Cell Death Ligand 1 (PD-L1, CD274) in microvascular endothelial cells (MECs), including blood endothelial cells (BECs) and lymphatic endothelial cells (LECs), and immune cell infiltration within tissues.

Methods: In our study, we utilized data from The Cancer Genome Atlas, a mouse subcutaneous xenograft model, and immunofluorescence and immunohistochemical staining to investigate the relationship between PD-L1 expression in melanoma MECs at different tumor stages and the infiltration of CD8+ T cells in tumor and normal organs, under conditions with and without anlotinib treatment.

Results: We found that PD-L1 expression was upregulated in tumor MECs, while anlotinib downregulated PD-L1 expression in both tumor and normal tissue MECs, corresponding with increased infiltration of CD8+ T cells in the tissues. Additionally, the antitumor effect of anlotinib was most pronounced when administered during the mid-stage of tumor development.

Conclusions: This study evaluated the most effective timing for anlotinib to downregulate PD-L1 expression in tumor and normal tissues to promote immune infiltration. Our findings may offer valuable insights for the clinical use of anlotinib and its potential side effects.

Keywords: PD-L1; anlotinib; immune checkpoints; melanoma; microvascular endothelial cells.