Simultaneous high PD-L1 and low VEGFR2 expression is associated with better overall survival in rectal cancer

Yun Ding; Yuanyuan Fu; Wei Wei; Weibin Huang; Zhuojun Zheng; Dachuan Zhang; Jiajia He; Xiao Zheng; Qi Wang; Yingting Liu; Wendong Gu; Jingting Jiang

doi:10.21037/tcr-20-3106

Simultaneous high PD-L1 and low VEGFR2 expression is associated with better overall survival in rectal cancer

Transl Cancer Res. 2021 Jan;10(1):499-508. doi: 10.21037/tcr-20-3106.

Authors

Yun Ding^{1

2

3

4}, Yuanyuan Fu^{1

2

3}, Wei Wei^{1

2

3

5}, Weibin Huang⁶, Zhuojun Zheng^{1

2

3}, Dachuan Zhang^{1

2

3}, Jiajia He^{1

2

3

6}, Xiao Zheng^{1

2

3}, Qi Wang^{1

2

3}, Yingting Liu^{1

2

3}, Wendong Gu^{1

2

3

4}, Jingting Jiang^{1

2

3}

Affiliations

¹ Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China.
² Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou, China.
³ Institute of Cell Therapy, Soochow University, Changzhou, China.
⁴ Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
⁵ Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
⁶ Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Abstract

Background: The aim of the present study was to analyze the association of programmed cell death-ligand 1 (PD-L1) and vascular endothelial growth factor receptor 2 (VEGFR2) expression levels with clinicopathological characteristics and survival to provide a treatment strategy for rectal cancer.

Methods: Immunohistochemical staining of VEGFR2 and PD-L1 was carried out, and the association of PD-L1 and VEGFR2 expression levels with clinicopathological characteristics and survival were investigated in 77 pair-matched rectal cancer patients.

Results: PD-L1 and VEGFR2 expression levels in surgical tumor tissues were higher than those in paired adjacent normal tissues, respectively (both P<0.05). The results of the 5-year overall survival (OS) analysis showed that patients with low VEGFR2 expression (66.7% vs. 43.5%, P=0.042) and high tumor PD-L1 expression (63.9% vs. 26.1%, P=0.001) in tumor tissues demonstrated significantly better OS. Patients with high TNM stage had poorer OS [hazard ratio (HR): 2.093, 95% confidence interval (CI): 1.027-4.087, P=0.030]. Similar results of poorer OS could be seen in patients with low tumor PD-L1 expression (HR: 3.365, 95% CI:1.747-6.481, P=0.005), as well as patients with high tumor VEGFR2 expression (HR: 0.418, 95% CI: 0.232-0.993, P=0.048).

Conclusions: The results indicated that tumor PD-L1 and VEGFR2 expression levels were associated with OS, and the combination of tumor PD-L1 and VEGFR2 levels might be an independent prognostic factor in rectal cancer.

Keywords: Programmed cell death-ligand 1 (PD-L1); overall survival (OS); rectal cancer; vascular endothelial growth factor receptor 2 (VEGFR2).