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Sci Rep. 2019;9(1):11131.

Prognostic implications of soluble programmed death-ligand 1 and its dynamics during chemotherapy in unresectable pancreatic cancer.

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제1저자 박현경 · 교신저자 오도연

소속 (4)
  1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  3. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. ohdoyoun@snu.ac.kr.
  4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ohdoyoun@snu.ac.kr.

Abstract

In pancreatic cancer, acquiring a sufficient amount of tumor tissue is an obstacle. The soluble form of PD-L1 (sPD-L1) may have immunosuppressive activity. Here, we evaluated the prognostic implications of sPD-L1 in unresectable pancreatic cancer. We prospectively enrolled 60 patients treated with first-line FOLFIRINOX chemotherapy. We collected blood samples at diagnosis, first response assessment and disease progression. Serum sPD-L1 levels were measured using enzyme-linked immunosorbent assays. The median sPD-L1 level was 1.7 ng/mL (range, 0.4-5.7 ng/mL). Patients with low sPD-L1 level (<4.6 ng/mL) at diagnosis showed better overall survival (OS) than those with high sPD-L1 level (P = 0.015). Multivariate analysis identified sPD-L1 and the neutrophil-to-lymphocyte ratio as independent prognostic factors for OS. During chemotherapy, more patients achieved complete response (CR)/partial response (PR) as their best response when sPD-L1 was decreased at the first response assessment (P = 0.038). In the patients who achieved CR/PR as their best response, sPD-L1 was significantly higher at the time of disease progression than at the first response assessment (P = 0.025). In conclusion, the sPD-L1 level at diagnosis exhibits a prognostic value in pancreatic cancer. Furthermore, sPD-L1 dynamics correlate with disease course and could be used to understand various changes in the tumor microenvironment during chemotherapy.

Figures

Figure 1
Figure 1 Survival outcomes. (A) Progression-free survival of patients stratified according to soluble programmed death-ligand 1 (sPD-L1) levels (median 4.1 vs. 7.8 months, P = 0.021). (B) Overall survival of patients stratified according to sPD-L1 levels (median 8.0 vs. 12.6 months, P = 0.003). (C) Overall survival of metastatic pancreatic cancer patients stratified according to sPD-L1 levels (median 8.4 months vs. 10.2 months, P = 0.028).
Figure 2
Figure 2 Comparison of soluble programmed death-ligand 1 (sPD-L1) levels among pancreatic cancer patients during FOLFIRINOX chemotherapy. (A) Time of diagnosis vs. first response assessment time point vs. disease progression time point (mean 2.6 ng/mL vs. 2.3 ng/mL vs. 2.6 ng/mL, respectively, P = 0.436) (B) Time of diagnosis vs. first response assessment time point vs. disease progression time point in patients who achieved complete response or partial response during chemotherapy (mean 2.5 ng/mL vs. 1.9 ng/mL vs. 3.5 ng/mL, respectively, P = 0.006).

그림 출처: PubMed Central 공개 논문 (PMC6668419)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2019-07-31
MeSH
Antineoplastic Combined Chemotherapy Protocols / therapeutic use · B7-H1 Antigen / metabolism · Biomarkers, Tumor / metabolism · Disease Progression · Female · Fluorouracil / therapeutic use · Humans · Irinotecan / therapeutic use · Leucovorin / therapeutic use · Male · Middle Aged · Oxaliplatin / therapeutic use · Pancreatic Neoplasms / drug therapy / metabolism / pathology · Prognosis · Prospective Studies · Tumor Microenvironment / drug effects
Substances
B7-H1 Antigen · Biomarkers, Tumor · CD274 protein, human · folfirinox · Oxaliplatin · Irinotecan · Leucovorin · Fluorouracil
참고문헌
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