Patterns and genomic correlates of PD-L1 expression in patients with biliary tract cancers.

Cholangiocarcinoma bile ducts extrahepatic gallbladder cancer (GBC) immunotherapy intrahepatic mutation

Journal

Journal of gastrointestinal oncology
ISSN: 2078-6891
Titre abrégé: J Gastrointest Oncol
Pays: China
ID NLM: 101557751

Informations de publication

Date de publication:
Dec 2019
Historique:
entrez: 18 1 2020
pubmed: 18 1 2020
medline: 18 1 2020
Statut: ppublish

Résumé

Patients with biliary tract cancer (BTC) have a dismal prognosis and limited treatment options. Given the potential for immunotherapy in patients with BTC, we studied the expression of programmed death ligand-1 (PD-L1)/programmed death-1 (PD-1) and evaluated for associated genetic alterations in patients with BTC. By immunohistochemistry (IHC), PD-L1 (SP142 antibody; ≥2+ and/or ≥5% staining on tumor cells considered positive) and PD-1 [NAT105 antibody; ≥1+ staining of tumor infiltrating lymphocytes (TILs) considered positive] expression was studied and next-generation sequencing (NGS) was performed using Caris Life Sciences' sequencing panel of 592 genes. A total of 652 patients with BTC were included in this study: 77 extrahepatic cholangiocarcinoma (ECC), 203 gallbladder cancer (GBC), and 372 intrahepatic cholangiocarcinoma (ICC). Of the 652 tumors 8.6% were PD-L1 positive with the following distribution: GBC 12.3% (25/203), ICC 7.3% (27/372), and ECC 5.2% (4/77). There was a statistically significant increase in BRAF, BRCA2, RNF43, and TP53 mutations in PD-L1 positive group as compared to PD-L1 negative. Among other biomarkers tested, TOP2A, tumor mutational burden (TMB) high (≥17 mutations per megabase) (10.7%), and microsatellite instability high (MSI-H) (7.1%) were increased in PD-L1 positive tumors versus PD-L1 negative tumors. PD-L1 expression was noted in a small percentage (8.6%) of patients with BTC. This finding suggests potential benefit of immunotherapy in this subset of patients. Furthermore, there was a statistically significant association between PD-L1 expression and certain genomic alterations (

Sections du résumé

BACKGROUND BACKGROUND
Patients with biliary tract cancer (BTC) have a dismal prognosis and limited treatment options. Given the potential for immunotherapy in patients with BTC, we studied the expression of programmed death ligand-1 (PD-L1)/programmed death-1 (PD-1) and evaluated for associated genetic alterations in patients with BTC.
METHODS METHODS
By immunohistochemistry (IHC), PD-L1 (SP142 antibody; ≥2+ and/or ≥5% staining on tumor cells considered positive) and PD-1 [NAT105 antibody; ≥1+ staining of tumor infiltrating lymphocytes (TILs) considered positive] expression was studied and next-generation sequencing (NGS) was performed using Caris Life Sciences' sequencing panel of 592 genes. A total of 652 patients with BTC were included in this study: 77 extrahepatic cholangiocarcinoma (ECC), 203 gallbladder cancer (GBC), and 372 intrahepatic cholangiocarcinoma (ICC).
RESULTS RESULTS
Of the 652 tumors 8.6% were PD-L1 positive with the following distribution: GBC 12.3% (25/203), ICC 7.3% (27/372), and ECC 5.2% (4/77). There was a statistically significant increase in BRAF, BRCA2, RNF43, and TP53 mutations in PD-L1 positive group as compared to PD-L1 negative. Among other biomarkers tested, TOP2A, tumor mutational burden (TMB) high (≥17 mutations per megabase) (10.7%), and microsatellite instability high (MSI-H) (7.1%) were increased in PD-L1 positive tumors versus PD-L1 negative tumors.
CONCLUSIONS CONCLUSIONS
PD-L1 expression was noted in a small percentage (8.6%) of patients with BTC. This finding suggests potential benefit of immunotherapy in this subset of patients. Furthermore, there was a statistically significant association between PD-L1 expression and certain genomic alterations (

Identifiants

pubmed: 31949927
doi: 10.21037/jgo.2019.08.08
pii: jgo-10-06-1099
pmc: PMC6955012
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1099-1109

Subventions

Organisme : NCI NIH HHS
ID : P50 CA210964
Pays : United States

Informations de copyright

2019 Journal of Gastrointestinal Oncology. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: K Mody—Research Support: Agios, Senwha Biosciences, Taiho, ArQule, AstraZeneca, Genentech, Incyte, Tracon Pharmaceuticals, Medimmune, Puma Biotechnology. Consulting: Astra Zeneca, Bayer, Celgene, Eisai, Exelixis, Ipsen, Merrimack, Vicus. M Saul and K Poorman—Employment: Caris Life Sciences. The other authors have no conflicts of interest to declare.

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Auteurs

Kabir Mody (K)

Gastrointestinal Oncology Program, Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.

Jason Starr (J)

Gastrointestinal Oncology Program, Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.

Michelle Saul (M)

Caris Life Sciences, Phoenix, AZ, USA.

Kelsey Poorman (K)

Caris Life Sciences, Phoenix, AZ, USA.

Benjamin A Weinberg (BA)

Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.

Mohamed E Salem (ME)

Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.

Ari VanderWalde (A)

West Cancer Center, Division of Hematology and Oncology, Department of Medicine, University of Tennessee, Memphis, TN, USA.

Anthony F Shields (AF)

Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.

Classifications MeSH