Prognostic value of programmed cell death ligand 1 expression in patients with intrahepatic cholangiocarcinoma: a meta-analysis

Feng Xian; Dacheng Ren; Jun Bie; Guohui Xu

doi:10.3389/fimmu.2023.1119168

Prognostic value of programmed cell death ligand 1 expression in patients with intrahepatic cholangiocarcinoma: a meta-analysis

Front Immunol. 2023 Apr 17:14:1119168. doi: 10.3389/fimmu.2023.1119168. eCollection 2023.

Authors

Feng Xian^{1

2}, Dacheng Ren², Jun Bie², Guohui Xu³

Affiliations

¹ School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
² Department of Oncology, Nanchong Central Hospital, the Second Clinical Medical College, North Sichuan Medical College, Nanchong, China.
³ Department of Interventional Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.

Abstract

Background: Programmed cell death ligand 1 (PD-L1) is highly expressed in intrahepatic cholangiocarcinoma (ICC) tissues. But there is still a dispute over the prognostic value of PD-L1 in patients with ICC. This study aimed to evaluate the prognostic value of PD-L1 expression in patients with ICC.

Methods: We performed a meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. We searched the literature from PubMed, Embase, Web of Science, and the Cochrane Library up to December 5, 2022. Hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated to analyze the overall survival (OS), recurrence-free survival (RFS), and time to relapse. The quality of the studies was assessed using the Newcastle-Ottawa scale. Publication bias was assessed using a funnel plot and Egger's test.

Results: Ten trials with 1944 cases were included in this meta-analysis. The results showed that the low-PD-L1 group had a statistically significant advantage in OS (HR, 1.57; 95% CI, 1.38-1.79, P <0.00001), RFS (HR, 1.62; 95% CI, 1.34-1.97, P <0.00001), and time to relapse (HR, 1.60; 95% CI, 1.25-2.05, P = 0.0002) compared with the high-PD-L1 group. High programmed cell death (PD1)levels, on the other hand, were correlated with poorer OS (HR, 1.96; 95% CI, 1.43-2.70; P <0.0001) and RFS (HR, 1.87; 95% CI, 1.21-2.91; P = 0.005). Multivariate analysis showed that PD-L1 could act as an independent predictor for OS (HR, 1.48; 95% CI, 1.14-1.91; P = 0.003) and RFS (HR, 1.74; 95% CI, 1.22-2.47; P = 0.002), and PD1 acted as an independent predictor for OS (HR, 1.66; 95% CI, 1.15-2.38; P = 0.006).

Conclusion: This meta-analysis demonstrated that high PD-L1/PD1 expression is associated with poor survival in ICC. PD-L1/PD1 may be a valuable prognostic and predictive biomarker and potential therapeutic target in ICC.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022380093.

Keywords: intrahepatic carcinoma; meta-analysis; prognostic value; programmed cell death 1 (PD-1); programmed cell death ligand 1 (PDL1).

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

B7-H1 Antigen / metabolism
Bile Duct Neoplasms*
Bile Ducts, Intrahepatic / metabolism
Cholangiocarcinoma*
Humans
Ligands
Neoplasm Recurrence, Local
Prognosis

Substances

B7-H1 Antigen
Ligands

Grants and funding

This study was funded by the Natural Science Foundation of Sichuan (No. 23ZDYF1517). Science and Technology Project of Nanchong (No. 22SXQT0066).