Prevalence and prognostic role of PD-L1 in patients with gynecological cancers: A systematic review and meta-analysis

Crit Rev Oncol Hematol. 2023 Sep:189:104084. doi: 10.1016/j.critrevonc.2023.104084. Epub 2023 Aug 1.

Abstract

Objective: Our study aims to evaluate programmed cell death ligand-1 (PD-L1) expression and its prognostic significance in cervical cancer (CC), endometrial cancer (EC) and ovarian cancer (OC).

Methods: Several electronic databases were searched. Fixed effects models or random effects models were employed to calculate the pooled prevalence of PD-L1 positivity and pooled hazard ratios (HRs) as appropriate. Heterogeneity and publication bias were also assessed.

Results: The pooled prevalence of PD-L1 positivity was 58.1%, 33.8% and 37.5% for CC, EC and OC patients, respectively. There were significant differences in the pooled estimates after stratification by PD-L1-positive assessment criteria and antibody clones. PD-L1 positivity was associated with worse OS in CC and EC patients and poorer progression-free survival (PFS) in CC patients.

Conclusions: The prevalence of PD-L1-positive expression was considerably high in CC and modestly high in EC and OC patients. PD-L1 expression has the potential to be a prognostic biomarker for predicting the clinical outcomes of patients with CC and EC but not OC.

Keywords: Gynecological cancers; Prevalence; Prognosis; Programmed cell death ligand-1; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • B7-H1 Antigen / genetics
  • B7-H1 Antigen / metabolism
  • Endometrial Neoplasms*
  • Female
  • Humans
  • Ovarian Neoplasms*
  • Prevalence
  • Prognosis
  • Proportional Hazards Models
  • Uterine Cervical Neoplasms*

Substances

  • B7-H1 Antigen