ESTRO 2023

Session Item

Gynaecological

Session Code: 6014

Session Type: Poster (Digital)

Track: Clinical

Programmed death ligand (PD-L1) expression and survival outcome in radically treated cervical cancer

Aparna Mullangath Prakasan, India

Presentation Number: PO-1418

Abstract

Abstract Title:

Programmed death ligand (PD-L1) expression and survival outcome in radically treated cervical cancer

Authors:

Aparna Mullangath Prakasan¹, Lakshmi S², Aryakrishna S L³, Preethi T Ramadas⁴, Aswin Kumar⁵, Susan Mathews⁵, John Joseph⁵, Jinto George⁶, Aleyamma Mathew⁶, Francis V James⁷

¹Regional Cancer Center, Thiruvananthapuram, Radiation Oncology, Thiruvannathapuram, India; ²Regional Cancer Centre, Thiruvananthapuram, Division of Cancer Research, Thiruvananthapuram, India; ³Regional Cancer Centre, Thiruvananthapuram, Radiation Oncology, Thiruvananthapuram, India; ⁴Regional Cancer Centre, Thiruvananthapuram, Pathology, Thiruvananthapuram, India; ⁵Regional Cancer Centre, Thiruvananthapuram, Radiation Oncology, Thiruvananthapuram, India; ⁶Regional Cancer Centre, Thiruvananthapuram, Division of Cancer Epidemiology & Biostatistics, Thiruvananthapuram, India; ⁷ Regional Cancer centre, Thiruvannathapuram, Radiation Oncology, Thiruvannathapuram, India

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Purpose or Objective

Immunotherapy has been reported to be beneficial in PD-L1-expressing tumors in many cancers. There are also reports of poor prognosis of patients with tumors expressing PD L1[1]. A study was done to see the pattern of expression of PD-L1 in patients with locally advanced carcinoma cervix and to correlate with clinicopathological parameters in our department and was reported earlier [2]. This study was to find out whether PD -L1 expression is related to the survival outcome of the patient group.

Material and Methods

Formalin-fixed, paraffin-embedded cervical biopsy specimens of 100 consecutive cervical carcinoma patients were collected in 2018. Immunohistochemical (IHC) staining for PD-L1 was performed using a scoring system developed by Reddy OL et al [3]. Both nuclear and cytoplasm immunostaining of tumor cells was evaluated using the intensity of the staining and the estimated percentage of positive tumor cells. PD L1 positivity was taken as any membrane positivity with the intensity of staining 1,2 or 3. Data from 95 patients treated with radical chemoradiation were collected with follow-up until September 2022. Survival estimates were generated using Kaplan –Meier method and compared based on PD-L1 status.

Results

The mean age of the population was 57 years. PD-L1 was positive in 56 patients (58.9 %), 44 out of 77 patients (57.1 %) with squamous cell carcinoma, and 11 out of 14 patients (78.5%) with adenocarcinoma.

At a median follow-up of 50.4 months, the four-year survival probability of the entire population was 74.7% (SE -4.7%). The 4 years survival probability for the PD L1 negative population was 74.5% (SE- 7.3) and PD L1 positive population was 78.2%(SE- 8.8) with a P value of 0.844. The four-year disease-free survival probability for the PD L1 negative group was 72.6% (SE -7.4%) and the PD-L1 positive group was 83.5% (SE -5%). The local recurrences seen were 8.9 % in PD -L1 negative and 7.6 % in PD-L1-positive patients. We could not find any relation between PD L-1 expression and survival outcome.

Conclusion

No significant differences were observed in the survival or recurrence of patients with cancer cervix expressing PD L-1 compared to non-expressors. This could also be due to a smaller number of patients examined or subjectivity in the interpretation of IHC-based PD-L1 tests. A combined positivity score might be more useful in this regard.

Table 1 shows the Clinicopathological characteristics of the study population.

References

1. Gu, X., Dong, M. et al. Elevated PD-L1 expression predicts poor survival outcomes in patients with cervical cancer.2019; 19: 146.Cancer Cell Int.
2. Aryakrishna SL, S. Lakshmi, T.R. et al. Programmed death ligand - 1 (PD L-1) expression in cervical cancer patients. Annals of Oncology;2020,31 (suppl_4): S551-S589.
3. Reddy OL, Shintaku PI, Moatamed NA. Programmed death-ligand 1 (PD-L1) is expressed in a significant number of uterine cervical carcinomas. Diagn Pathol. 2017 Jun 17;12(1):45.