Clinicopathologic and Prognostic Significance of Programmed Cell Death Ligand 1 Expression in Patients with Non-Medullary Thyroid Cancer: A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND:

Evidence has shown that programmed cell death ligand 1 (PD-L1) overexpression is associated with poor prognosis and resistance to immune therapies in several human cancers. However, data on the prognostic significance of PD-L1 expression in thyroid cancer are limited and remain controversial. This systematic review and meta-analysis aimed to evaluate comprehensively the clinicopathologic significance and prognostic value of PD-L1 expression in non-medullary thyroid cancers.

METHODS:

Electronic databases, including Medline/PubMed, EMBASE, and the Cochrane Library, were searched up until July 5, 2017. In total, seven comparisons (from six articles) comprising 1421 patients were included in the pooled analysis.

RESULTS:

There was moderate quality evidence from four studies (n = 721) that shows positive PD-L1 expression was significantly associated with poor survival among thyroid cancer patients (pooled hazard ratio = 3.73 [confidence interval (CI) 2.75-5.06]). Increased PD-L1 expression was also found to be significantly associated with disease recurrence (odds ratio = 1.95 [CI 1.15-3.32]) and concurrent thyroiditis (odds ratio = 1.65 [CI 1.09-2.51]).

CONCLUSIONS:

The results confirm the prognostic significance of PD-L1 expression in thyroid cancer patients. PD-L1 expression has the potential to be implemented as a prognostic biomarker used to guide clinicians in identifying patients with more aggressive cancers, and for the selection of individuals that would derive durable clinical benefit from anti-PD-1/PD-L1 immunotherapy. Prospective clinical trials will be useful to support these findings.

• Authors: Marra Aghajani, Susannah Graham, Charles McCafferty, Christina Abdel Shaheed, Tara Roberts, Paul DeSouza, Tao Yang, Navin Niles
• Journal: Thyroid : official journal of the American Thyroid Association (Thyroid) Vol. 28 Issue 3 Pg. 349-361 (03 2018) ISSN: 1557-9077 [Electronic] United States
• PMID: 29455638 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• B7-H1 Antigen
• Biomarkers, Tumor
• CD274 protein, human

Topics

• B7-H1 Antigen (metabolism)
• Biomarkers, Tumor (metabolism)
• Humans
• Neoplasm Recurrence, Local (metabolism, mortality, pathology)
• Prognosis
• Survival Rate
• Thyroid Neoplasms (metabolism, mortality, pathology)