Journal Article

DKFZ-2023-02492

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Dynamic Up-Regulation of PD-L1 in the Progression of Oral Squamous Cell Carcinoma.

Steen, S. ; Semmelmayer, K. ; Flechtenmacher, C. ; Hoffmann, J. ; Freier, K. ; Horn, D. ; Hess, J.DKFZ* ; Freudlsperger, C. ; Moratin, J.

2023
Molecular Diversity Preservation International Basel

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Please use a persistent id in citations: doi:10.3390/ijms242216386

Abstract: The introduction of immune checkpoint inhibition for recurrent and metastatic head and neck cancer has brought a new treatment option for patients suffering from advanced oral cancers without a chance for curation using surgery or radiotherapy. The application of immune checkpoint inhibitors in most cases is based on the expression levels of PD-L1 in the tumor tissue. To date, there is a lack of data on the dynamic regulation of PD-L1 during disease progression. Therefore, this study aimed to evaluate the expression levels of PD-L1 in a large cohort of patients (n = 222) with oral squamous cell carcinoma including primary and recurrent tumors. Semiautomatic digital pathology scoring was used for the assessment of PD-L1 expression levels in primary and recurrent oral squamous cell carcinoma. Survival analysis was performed to evaluate the prognostic significance of the protein expression at different stages of the disease. We found a significant up-regulation of PD-L1 expression from primary disease to recurrent tumors (mean PD-L1 H-scores: primary tumors: 47.1 ± 31.4; recurrent tumors: 103.5 ± 62.8, p < 0.001). In several cases, a shift from low PD-L1 expression in primary tumors to high PD-L1 expression in recurrent tumors was identified. Multivariate Cox regression analysis did not reveal a significantly higher risk of death (p = 0.078) or recurrence (p = 0.926) in patients with higher PD-L1 expression. Our findings indicate that the exclusive analysis of primary tumor tissue prior to the application of checkpoint blockade may lead to the misjudgment of PD-L1 expression in recurrent tumors.

Keyword(s): Humans (MeSH) ; Squamous Cell Carcinoma of Head and Neck (MeSH) ; Carcinoma, Squamous Cell: pathology (MeSH) ; B7-H1 Antigen: metabolism (MeSH) ; Up-Regulation (MeSH) ; Mouth Neoplasms: genetics (MeSH) ; Neoplasm Recurrence, Local: genetics (MeSH) ; Head and Neck Neoplasms (MeSH) ; HNSCC ; PD-L1 ; immune checkpoint inhibitor ; metastases ; oral cancer ; recurrence ; B7-H1 Antigen

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Contributing Institute(s):

1. Molekulare Grundlagen von HNO-Tumoren (E221)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2023

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