Tumour cell PD-L1 expression is prognostic in patients with malignant pleural effusion: the impact of C-reactive protein and immune-checkpoint inhibition

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Bahil Ghanim - , Karl Landsteiner University of Health Sciences, Karl Landsteiner Society (Author)
  • Anna Rosenmayr - , Karl Landsteiner University of Health Sciences (Author)
  • Paul Stockhammer - , University Hospital Essen, Medical University of Vienna (Author)
  • Melanie Vogl - , Karl Landsteiner University of Health Sciences, Karl Landsteiner Society (Author)
  • Ali Celik - , Gazi University (Author)
  • Aynur Bas - , Gazi University (Author)
  • Ismail Cuneyt Kurul - , Gazi University (Author)
  • Nalan Akyurek - , Gazi University (Author)
  • Alexander Varga - , Karl Landsteiner University of Health Sciences (Author)
  • Till Plönes - , University Hospital Essen (Author)
  • Agnes Bankfalvi - , University of Duisburg-Essen (Author)
  • Thomas Hager - , University of Duisburg-Essen (Author)
  • Martin Schuler - , University of Duisburg-Essen (Author)
  • Klaus Hackner - , Karl Landsteiner University of Health Sciences (Author)
  • Peter Errhalt - , Karl Landsteiner University of Health Sciences (Author)
  • Axel Scheed - , Karl Landsteiner University of Health Sciences, Karl Landsteiner Society (Author)
  • Gernot Seebacher - , Karl Landsteiner University of Health Sciences, Karl Landsteiner Society (Author)
  • Balazs Hegedus - , University Hospital Essen (Author)
  • Elisabeth Stubenberger - , Karl Landsteiner University of Health Sciences, Karl Landsteiner Society (Author)
  • Clemens Aigner - , University Hospital Essen (Author)

Abstract

Malignant pleural effusion (MPE) confers dismal prognosis and has limited treatment options. While immune-checkpoint inhibition (ICI) proved clinical efficacy in a variety of malignancies, data on the prognostic role of PD-L1 in MPE is scarce. We retrospectively studied PD-L1 tumour proportion score and Ki-67 index in pleural biopsies or cytologies from 123 patients (69 lung cancer, 25 mesothelioma, and 29 extrathoracic primary malignancies). Additionally, the impact of C-reactive protein (CRP) and platelet count was also analysed. Median overall survival (OS) after MPE diagnosis was 9 months. Patients with PD-L1 positive tumours (≥1%) had significantly shorter OS than patients with negative PD-L1 status (p = 0.031). CRP and Ki-67 index were also prognostic and remained independent prognosticators after multivariate analysis. Interestingly, Ki-67 index and CRP influenced the prognostic power of PD-L1. Finally, patients receiving ICI tended to have a longer median OS and CRP - but not PD-L1 - was a significant prognosticator in this subgroup. In summary, histological and circulating biomarkers should also be taken into account as potential biomarkers in ICI therapy and they may have an impact on the prognostic power of PD-L1. Our findings might help personalizing immune-checkpoint inhibition for patients with MPE and warrant further prospective validation.

Details

Original languageEnglish
Article number5784
JournalScientific reports
Volume10
Issue number1
Publication statusPublished - 1 Dec 2020
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 32238865

Keywords

Sustainable Development Goals

ASJC Scopus subject areas