To Örebro University

oru.seÖrebro University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Discordance of PD-L1 status between primary and metastatic breast cancer: A systematic review and meta-analysis
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Theme Cancer, Karolinska University Hospital, Stockholm, Solna, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Theme Cancer, Karolinska University Hospital, Stockholm, Solna, Sweden.
Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Theme Cancer, Karolinska University Hospital, Stockholm, Solna, Sweden.
Show others and affiliations
2021 (English)In: Cancer Treatment Reviews, ISSN 0305-7372, E-ISSN 1532-1967, Vol. 99, article id 102257Article, review/survey (Refereed) Published
Abstract [en]

INTRODUCTION: Programmed cell death ligand 1 (PD-L1) expression is predictive for benefit from immunotherapy in several human malignancies including triple negative breast cancer. Lower positivity rates but a larger relative benefit from atezolizumab has been implied when PD-L1 status is assessed at metastatic sites. We aimed to study the discordance of PD-L1 expression between primary tumor and metastasis in breast cancer due to its potential clinical utility.

METHODS: Cochrane Library, Embase, Medline and Web of science were searched for studies reporting on PD-L1 expression in primary and metastatic breast cancer, followed by data extraction. Outcomes included pooled PD-L1 positivity rates in tumor cells, immune cells or both in primary tumor and metastasis, PD-L1 discordance between matched primary tumors and metastasis and direction of discordance.

RESULTS: Of 2552 identified entries following de-duplication, 20 studies fulfilled the predefined inclusion criteria. Pooled PD-L1 positivity rate was higher in primary tumors compared to metastasis when assessed in immune cells (51.2% vs 37.1% p < 0.001) and tumor/immune cells (30.1% vs 14.6% p < 0.001), but not in tumor cells (18.7% vs 17.8% p = 0.65). PD-L1 positivity was lowest when assessed in bone metastases (12%) and highest in lymph nodes (60%). Discordance between primary tumors and metastasis was bidirectional, with higher pooled discordance rates when PD-L1 expression was assessed in immune compared to tumor cells (39.5% vs 13.6%, p < 0.001).

CONCLUSION: The observed considerable discordance between PD-L1 status in primary and metastatic breast cancer emphasizes the importance of appropriate tissue sampling when selecting patients for immunotherapy.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 99, article id 102257
Keywords [en]
Breast cancer, Discordance, Immunotherapy, Metastasis, PD-L1
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-93451DOI: 10.1016/j.ctrv.2021.102257ISI: 000693067900017PubMedID: 34237488Scopus ID: 2-s2.0-85109147784OAI: oai:DiVA.org:oru-93451DiVA, id: diva2:1584537
Funder
Region Stockholm, K 2017-4577Swedish Cancer Society, CAN 2017/1043The Cancer Research Funds of RadiumhemmetSwedish Research CouncilEuropean CommissionKnut and Alice Wallenberg FoundationAvailable from: 2021-08-12 Created: 2021-08-12 Last updated: 2021-09-17Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records

Valachis, Antonis

Search in DiVA

By author/editor
Valachis, Antonis
By organisation
School of Medical SciencesÖrebro University Hospital
In the same journal
Cancer Treatment Reviews
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 62 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf