A pooled analysis of the prognostic value of PD-L1 in melanoma: evidence from 1062 patients

Jing Yang; Meilian Dong; Yifang Shui; Yue Zhang; Zhigang Zhang; Yin Mi; Xiaoxiao Zuo; Li Jiang; Ke Liu; Zheyan Liu; Xiaobin Gu; Yonggang Shi

doi:10.1186/s12935-020-01187-x

A pooled analysis of the prognostic value of PD-L1 in melanoma: evidence from 1062 patients

Cancer Cell Int. 2020 Mar 30:20:96. doi: 10.1186/s12935-020-01187-x. eCollection 2020.

Authors

Jing Yang¹, Meilian Dong¹, Yifang Shui², Yue Zhang¹, Zhigang Zhang¹, Yin Mi¹, Xiaoxiao Zuo¹, Li Jiang¹, Ke Liu¹, Zheyan Liu¹, Xiaobin Gu¹, Yonggang Shi¹

Affiliations

¹ 1Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan People's Republic of China.
² 2Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan People's Republic of China.

Abstract

Background: Programmed death-ligand 1 (PD-L1) was the first identified ligand of programmed death-1 (PD-1). PD-1/PD-L1 interactions inhibit T cell-mediated immune responses, limit cytokine production, and promote tumor immune escape. Recently, many studies have investigated the prognostic value of PD-L1 expression in patients with melanoma. However, the results of these analyses remain a subject of debate. We have therefore carried out a meta-analysis to identify the prognostic role of PD-L1 in melanoma.

Methods: A thorough medical literature search was performed in the databases PubMed, Web of Science, and Embase until October 2019. The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated to evaluate the correlation between PD-L1 overexpression and prognosis. Publication bias was evaluated using Begg's test and Egger's test.

Results: Thirteen articles with 1062 enrolled patients were included in this meta-analysis. High PD-L1 expression did not correlate with overall survival (OS) (HR = 0.93, 95% CI 0.57-1.52, P = 0.781) or progression-free survival (PFS) (HR = 0.82, 95% CI 0.43-1.54, P = 0.535). However, PD-L1 overexpression correlated with the absence of lymph node (LN) metastasis (OR = 0.46, 95% CI 0.22-0.95, P = 0.036). Further, there was no significant relationship between PD-L1 expression and sex (OR = 1.29, 95% CI 0.90-1.84, P = 0.159), age (OR = 0.90, 95% CI 0.51-1.57, P = 0.708), or Eastern Cooperative Oncology Group Performance Status (OR = 0.55, 95% CI 0.06-4.83, P = 0.592).

Conclusions: This meta-analysis suggested that PD-L1 expression did not predict an inferior prognosis in patients with melanoma. However, high PD-L1 expression was associated with absence of LN metastasis in such patients.

Keywords: Melanoma; Meta-analysis; PD-L1; Prognosis; Risk factor.