Significant association of PD-L1 expression with human papillomavirus positivity and its prognostic impact in oropharyngeal cancer. (May 2019)

• Record Type: Journal Article
• Authors: Hong, Angela M.; Ferguson, Peter; Dodds, Tristan; Jones, Deanna; Li, Mengbo; Yang, Jean; Scolyer, Richard A
• Is Part Of: Oral oncology. Volume 92(2019)
• Page Start: 33
• Page End: 39
• Publication Date: 2019-05
• Subjects: Oropharyngeal cancer -- Head and neck -- PD-L1 -- Human papillomavirus -- Tumour infiltrating lymphocytes; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.03.012
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: HPV-positive OPSCC were significantly more likely to express PD-L1 than HPV-negative OPSCC. Relative to HPV-positive/PD-L1-positive OPSCC, HPV negative/PD-L1 negative OPSCC were more likely to recur locoregionally and die. Within the HPV positive cases, PD-L1 expression also significantly impacted on the outcomes. An evidence of an interaction between HPV status and PD-L1 expression was found for overall survival. Abstract: Background: The programmed death pathway plays a role in persistent human papillomavirus (HPV) infection as well as in resistance to immune elimination during malignant progression. In this study, we examined PD-L1 expression by immunohistochemistry and tumour infiltrating lymphocytes (TIL) in 214 patients with oropharyngeal squamous cell cancer (OPSCC) to assess its clinical significance. Results: HPV-positive OPSCC were significantly more likely to express PD-L1 than HPV-negative OPSCC (85.2% vs 57.1%, p < 0.05). PD-L1 staining was more likely to be associated with TILs in HPV-positive OPSCC (67.9% vs 49.6%, p = 0.01). Relative to those patients with HPV-positive/PD-L1-positive OPSCC, patients with HPV negative/PD-L1 negative OPSCC were 6.4 times more likely to develop a local recurrence, 5.8 times more likely to develop an event and 6.5 times more likely to die. Within the HPV positive cases, PD-L1 expression also significantly impacted on the outcomes with PD-L1 negative cases more likely to develop a locoregional recurrence (HR 4.16), to have an event (HR 2.5) and to die (HR 3.16). Evidence of an interaction between HPV status and PD-L1 expression was found for overall survival (p < 0.005). Conclusion: Our findings suggested that different immune profiles in oropharyngeal cancer by HPV status and the effect of HPV on the outcomes is modified by PD-L1 expression.