Research Papers:
PD-L1 expression in tonsillar cancer is associated with human papillomavirus positivity and improved survival: implications for anti-PD1 clinical trials
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Abstract
Angela M Hong1, Ricardo E Vilain2,3, Sarah Romanes4, Jean Yang4, Elizabeth Smith2, Deanna Jones1, Richard A Scolyer1,2, C Soon Lee1,2,5, Mei Zhang1, Barbara Rose1
1Sydney Medical School, The University of Sydney, NSW, Australia
2Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia
3Pathology North (Hunter), John Hunter Hospital, Newcastle, NSW, Australia
4School of Mathematics and Statistics, The University of Sydney, NSW, Australia
5Discipline of Pathology, School of Medicine, Western Sydney University, NSW, Australia
Correspondence to:
Angela M Hong, email: [email protected]
Keywords: tonsillar cancer, oropharyngeal cancer, human papillomavirus, PD-L1, p16
Received: August 15, 2016 Accepted: October 13, 2016 Published: October 20, 2016
ABSTRACT
In this study, we examined PD-L1 expression by immunohistochemistry in 99 patients with tonsillar cancer and known human papillomavirus (HPV) status to assess its clinical significance. We showed that the pattern of PD-L1 expression is strongly related to HPV status. The PD-L1 positivity rate was 83.3% in HPV-positive cases and 56.9% in HPV-negative cases (p < 0.05). Patients with HPV-positive/PD-L1-positive cancer had significantly better event free survival and overall survival compared with patients with HPV-negative/PD-L1-negative cancer. Relative to those patients with HPV-negative/PD-L1-negative disease who had the highest risk of death, patients with HPV-positive/PD-L1-positive cancers had a 2.85 fold lower risk of developing an event (HR 0.35, 95% CI: 0.16–0.79) and a 4.5 fold lower risk of death (HR =0.22, 95% CI: 0.09–0.53). Our findings will help to guide future clinical trial design in immunotherapy based on PD-L1 expression in tonsillar cancer.
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