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World J Urol. 2019 Sep 5. doi: 10.1007/s00345-019-02896-3. [Epub ahead of print]

Clinical interest of PD-L1 immuno-histochemistry expression as a predictive factor of Bacillus Calmette Guerin (BCG) efficacy in refractory high-risk non-muscle-invasive bladder cancer (NMIBC).

Author information

1
Department of Urology, Charles Nicolle Rouen University Hospital, 1 rue de Germont, 76031, Rouen Cedex, France.
2
Department of Pathology, Rouen University Hospital, Rouen, France.
3
Department of Biostatistics, Rouen University Hospital, Rouen, France.
4
Department of Pathology, Kremlin Bicêtre Hospital, Paris, France.
5
Department of Urology, Kremlin Bicêtre Hospital, Paris, France.
6
Department of Urology, Charles Nicolle Rouen University Hospital, 1 rue de Germont, 76031, Rouen Cedex, France. Christian.Pfister@chu-rouen.fr.
7
Clinical Investigation Center, Inserm 6204, Onco-Urology, Rouen, France. Christian.Pfister@chu-rouen.fr.

Abstract

OBJECTIVE:

To assess PD-L1 expression in tumor (TC) and tumor infiltrating immune cells (IC) as a predictive factor of BCG therapy failure in high-risk NMIBC.

MATERIALS AND METHODS:

Patients treated with complete resection followed by bladder BCG instillation for high-risk NMIBC were included. Early recurrence (ER) was defined as tumor recurrence after BCG induction course. The association between ER and immuno-histochemistry PD-L1 (E1L3N clone) expression by tumors cells (TC) and tumor infiltrating immune cells (IC) was investigated using an exact Fisher test variant.

RESULTS:

A total of 186 patients were included, of whom 38 (20.4%) were ER, 35 (18.8%) were positive for TC PD-L1 expression and 60 (32.3%) were positive for IC PD-L1. ER was not significantly (p = 0.97) more frequent in the TC PD-L1 ≥ 1% group (n = 7, 20.0%) than in the TC PD-L1-negative group (n = 31, 20.5%). Patients with IC PD-L1 negative had ER in 15 (19.2%) cases and patients with IC PD-L1 ≥ 1% had ER in 23 (21.3%) cases. PD-L1-positive expression for IC (threshold > 1%) was correlated with immune infiltrate density (95.2% dense immune infiltrate vs 47.2% low immune infiltrate, p < 0.05), with increased expression of PD-L1 by IC after BCG therapy (p = 0.006).

CONCLUSION:

No association was observed between immuno-histochemistry PD-L1 positivity and ER after BCG therapy. Nevertheless, the relationship between immune infiltrate and PD-L1 positivity confirmed the interest of assessing the immune infiltrate density to define tumor's profile.

KEYWORDS:

BCG; Bladder cancer; PD-L1

PMID:
31486884
DOI:
10.1007/s00345-019-02896-3

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