Tumour cell PD-L1 expression is prognostic in patients with malignant pleural effusion: the impact of C-reactive protein and immune-checkpoint inhibition

Bahil Ghanim, Anna Rosenmayr, Paul Stockhammer, Melanie Vogl, Ali Celik, Aynur Bas, Ismail Cuneyt Kurul, Nalan Akyurek, Alexander Varga, Till Plönes, Agnes Bankfalvi, Thomas Hager, Martin Schuler, Klaus Hackner, Peter Errhalt, Axel Scheed, Gernot Seebacher, Balazs Hegedus, Elisabeth Stubenberger, Clemens Aigner

Research output: Journal article (peer-reviewed)Journal article

9 Citations (Scopus)

Abstract

Malignant pleural effusion (MPE) confers dismal prognosis and has limited treatment options. While immune-checkpoint inhibition (ICI) proved clinical efficacy in a variety of malignancies, data on the prognostic role of PD-L1 in MPE is scarce. We retrospectively studied PD-L1 tumour proportion score and Ki-67 index in pleural biopsies or cytologies from 123 patients (69 lung cancer, 25 mesothelioma, and 29 extrathoracic primary malignancies). Additionally, the impact of C-reactive protein (CRP) and platelet count was also analysed. Median overall survival (OS) after MPE diagnosis was 9 months. Patients with PD-L1 positive tumours (≥1%) had significantly shorter OS than patients with negative PD-L1 status (p = 0.031). CRP and Ki-67 index were also prognostic and remained independent prognosticators after multivariate analysis. Interestingly, Ki-67 index and CRP influenced the prognostic power of PD-L1. Finally, patients receiving ICI tended to have a longer median OS and CRP - but not PD-L1 - was a significant prognosticator in this subgroup. In summary, histological and circulating biomarkers should also be taken into account as potential biomarkers in ICI therapy and they may have an impact on the prognostic power of PD-L1. Our findings might help personalizing immune-checkpoint inhibition for patients with MPE and warrant further prospective validation.

Original languageEnglish
Article number5784
Pages (from-to)5784
JournalScientific Reports
Volume10
Issue number1
DOIs
Publication statusPublished - 1 Dec 2020

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological/therapeutic use
  • B7-H1 Antigen/analysis
  • C-Reactive Protein/analysis
  • Female
  • Humans
  • Immunotherapy
  • Lung Neoplasms/blood
  • Male
  • Mesothelioma, Malignant/blood
  • Middle Aged
  • Pleural Effusion, Malignant/blood
  • Prognosis
  • Retrospective Studies

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