The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer: A meta-analysis of 50 studies with 11,383 patients

AME Lung Cancer Collaborative Group

Research output: Contribution to journalArticle

Abstract

Background: We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer. Methods: The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2nd, 2018, for articles relating to PD-L1 expression detected by immunohistochemistry (IHC) and lung cancer patient prognosis. Results: Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PDL1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95% CI: 1.24–1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I–III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PDL1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002), EGFR wild-type status (P<0.001) and KRAS mutations (P=0.393). However, age (P=0.15) and ALK rearrangements (P=0.567) had no bearing on PD-L1 expression. Conclusions: PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.

Original languageEnglish (US)
Pages (from-to)429-449
Number of pages21
JournalTranslational Lung Cancer Research
Volume8
Issue number4
DOIs
StatePublished - Jan 1 2019

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Meta-Analysis
Lung Neoplasms
Immunohistochemistry
Ligands
Survival
Confidence Intervals
Lymph
PubMed
Neoplasms
Biomarkers
Odds Ratio
Databases
Neoplasm Metastasis
Mutation

Keywords

  • Lung cancer
  • Meta-analysis
  • Prognosis
  • Programmed cell death ligand 1

ASJC Scopus subject areas

  • Oncology

Cite this

@article{93244a0da7f24cef8e49aabd424ddb52,
title = "The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer: A meta-analysis of 50 studies with 11,383 patients",
abstract = "Background: We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer. Methods: The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2nd, 2018, for articles relating to PD-L1 expression detected by immunohistochemistry (IHC) and lung cancer patient prognosis. Results: Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95{\%} confidence intervals (CIs) suggested that PDL1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95{\%} CI: 1.24–1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5{\%} was taken as the cutoff value (P=0.000), the patients were in early stage (I–III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PDL1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002), EGFR wild-type status (P<0.001) and KRAS mutations (P=0.393). However, age (P=0.15) and ALK rearrangements (P=0.567) had no bearing on PD-L1 expression. Conclusions: PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.",
keywords = "Lung cancer, Meta-analysis, Prognosis, Programmed cell death ligand 1",
author = "{AME Lung Cancer Collaborative Group} and Huijuan Li and Yangyang Xu and Bing Wan and Yong Song and Ping Zhan and Yangbo Hu and Qun Zhang and Fang Zhang and Hongbing Liu and Tianhong Li and Haruhiko Sugimura and Federico Cappuzzo and Dang Lin and Tangfeng Lv",
year = "2019",
month = "1",
day = "1",
doi = "10.21037/tlcr.2019.08.04",
language = "English (US)",
volume = "8",
pages = "429--449",
journal = "Translational Lung Cancer Research",
issn = "2226-4477",
publisher = "Society for Translational Medicine (STM)",
number = "4",

}

TY - JOUR

T1 - The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer

T2 - A meta-analysis of 50 studies with 11,383 patients

AU - AME Lung Cancer Collaborative Group

AU - Li, Huijuan

AU - Xu, Yangyang

AU - Wan, Bing

AU - Song, Yong

AU - Zhan, Ping

AU - Hu, Yangbo

AU - Zhang, Qun

AU - Zhang, Fang

AU - Liu, Hongbing

AU - Li, Tianhong

AU - Sugimura, Haruhiko

AU - Cappuzzo, Federico

AU - Lin, Dang

AU - Lv, Tangfeng

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer. Methods: The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2nd, 2018, for articles relating to PD-L1 expression detected by immunohistochemistry (IHC) and lung cancer patient prognosis. Results: Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PDL1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95% CI: 1.24–1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I–III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PDL1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002), EGFR wild-type status (P<0.001) and KRAS mutations (P=0.393). However, age (P=0.15) and ALK rearrangements (P=0.567) had no bearing on PD-L1 expression. Conclusions: PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.

AB - Background: We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer. Methods: The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2nd, 2018, for articles relating to PD-L1 expression detected by immunohistochemistry (IHC) and lung cancer patient prognosis. Results: Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PDL1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95% CI: 1.24–1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I–III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PDL1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002), EGFR wild-type status (P<0.001) and KRAS mutations (P=0.393). However, age (P=0.15) and ALK rearrangements (P=0.567) had no bearing on PD-L1 expression. Conclusions: PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.

KW - Lung cancer

KW - Meta-analysis

KW - Prognosis

KW - Programmed cell death ligand 1

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U2 - 10.21037/tlcr.2019.08.04

DO - 10.21037/tlcr.2019.08.04

M3 - Article

AN - SCOPUS:85072524540

VL - 8

SP - 429

EP - 449

JO - Translational Lung Cancer Research

JF - Translational Lung Cancer Research

SN - 2226-4477

IS - 4

ER -