PD-L1 and VEGFR-2 expression in synchronous metastatic renal cell carcinoma treated with targeted therapy following cytoreductive nephrectomy.

Abstract

OBJECTIVES:

Few studies have independently investigated the population of patients with synchronous metastatic renal cell carcinoma (smRCC). In this study, we evaluated programmed death protein-ligand 1 (PD-L1) and vascular endothelial growth factor receptor 2 (VEGFR-2) expression in primary tumor tissue of smRCC.

METHODS:

A total of 96 patients with smRCC who were treated with cytoreductive nephrectomy followed by targeted therapy from January 2006 to January 2013 were identified. PD-L1 and VEGFR-2 expression were evaluated by immunohistochemistry. Kaplan-Meier and Cox methods were used for analysis.

RESULTS:

PD-L1 and VEGFR-2 protein immunopositivity were observed in 39.6% (38 of 96) and 58.3% (56 of 96) of patients, respectively. A significant correlation was detected between VEGFR-2 and PD-L1 expression (P = 0.030). Based on PD-L1 and VEGFR-2 expression, patients with intermediate-risk disease (n = 63) were divided into 4 subgroups including patients who were PD-L1 (+) VEGFR-2 (+) (n = 21), PD-L1 (+) VEGFR-2 (-) (n = 11), PD-L1 (-) VEGFR-2 (+) (n = 15) and PD-L1 (-) VEGFR-2 (-) (n = 16). Compared to the PD-L1 (-) VEGFR-2 (+), PD-L1 (+) VEGFR-2 (+) and PD-L1 (-) VEGFR-2 (-) groups, patients in the PD-L1 (+) VEGFR-2 (-) group had shorter progression-free survival (median, 9.0 vs. 20.0, 16.0 and 15.5 months, P < 0.05) and overall survival (median, 14.0 vs. 33.0, 24.0 and 26.5 months, P < 0.05).

CONCLUSIONS:

Intermediate-risk smRCC patients with PD-L1-positive and VEGFR-2-negative expression who were treated with targeted therapy following cytoreductive nephrectomy had poor prognoses. We suggest that other treatments beyond sunitinib or sorafenib may be explored in this subgroup.

• Authors: Weixing Jiang, Dong Wang, Xiaoqi Liu, Wei Zheng, Li Wen, Hongzhe Shi, Huijuan Zhang, Aiping Zhou, Changling Li, Jianhui Ma, Shan Zheng, Jianzhong Shou
• Journal: Urologic oncology (Urol Oncol) Vol. 39 Issue 1 Pg. 78.e9-78.e16 (01 2021) ISSN: 1873-2496 [Electronic] United States
• PMID: 32988712 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• B7-H1 Antigen
• CD274 protein, human
• Sorafenib
• Vascular Endothelial Growth Factor Receptor-2
• Sunitinib

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• B7-H1 Antigen (biosynthesis)
• Carcinoma, Renal Cell (metabolism, secondary, therapy)
• Combined Modality Therapy
• Cytoreduction Surgical Procedures
• Female
• Humans
• Kidney Neoplasms (metabolism, pathology, therapy)
• Male
• Middle Aged
• Nephrectomy (methods)
• Retrospective Studies
• Sorafenib (therapeutic use)
• Sunitinib (therapeutic use)
• Vascular Endothelial Growth Factor Receptor-2 (biosynthesis)