Programmed Death Ligand 1 (PDL1) Expression in Neoadjuvant Triple-Negative Breast Cancer: Association With Chemotherapy Response and Residual Cancer Burden

IF 2 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Breast Journal Pub Date : 2025-09-30 DOI:10.1155/tbj/8856567

Atif Ali Hashmi, Noreen Wahid, Ghazala Mudassir, Muhammad Irfan, Umair Arshad Malik, Erum Yousuf Khan, Syed Muhammad Abu Bakar, Naveen Faridi

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引用次数: 0

Abstract

Background

Programmed death ligand 1 (PDL1) expression in tumors is linked to immune evasion in various cancers, making these patients potential candidates for PDL1 inhibitors. Although immune checkpoint blockade therapy has gained approval for breast cancer treatment, especially triple-negative breast cancer (TNBC), there is a lack of PDL1 expression data in Pakistani breast cancer patients. In our study, PDL1 expression was assessed in TNBC to determine eligibility for PDL1 inhibitors. Our study aimed to evaluate the frequency of PDL1 expression in TNBC. We also examined how PDL1 expression correlates with clinicopathological characteristics and prognostic factors in patients with TNBC. Moreover, the association of neoadjuvant chemotherapy response with PDL1 expression was also evaluated.

Methods

This cross-sectional study was conducted at the Liaquat National Hospital Histopathology Department from January 2022 to June 2023. A total of 128 biopsy-proven cases of TNBCs were administered neoadjuvant chemotherapy before surgery during this period. PDL1 immunohistochemical staining was performed on prechemotherapy needle biopsies. Expression was determined using the combined positive score (CPS). CPS is the number of PDL1-stained cells (tumor cells, lymphocytes, and macrophages) divided by the total number of viable tumor cells multiplied by 100. Cases with CPS ≥ 10 were considered PDL1-positive.

Results

Complete pathological response (pCR) was observed in 32.8% (n = 42) of cases. PDL1 expression was observed in 18.8% (n = 24) of cases. The majority of cases showed a high residual cancer burden (RCB-III) (n = 53, 41.4%). A significant association was noted between PDL1 expression and neoadjuvant chemotherapy response (p < 0.01). PDL1-positive cases had a higher pCR (n = 16, 66.7%) than PDL1-negative cases (n = 26, 25%). PDL1-positive cases showed a lower frequency of RCB-II-III (RCB-II: 8.3%; RCB-III: 0%) than PDL1-negative cases (RCB-II: 25%; RCB-III: 51%), with a significant p value (p < 0.01).

Conclusion

Overall, PDL1 expression was low in TNBC cases in our study; however, identifying these cases is important to identify those that can benefit from immunotherapy. We found a significant association of PDL1 expression with neoadjuvant chemotherapy response and RCB. Moreover, PDL1 positivity was associated with lower Ki67 index and older age. Therefore, we recommend routine PDL1 testing in all cases of TNBC to predict neoadjuvant chemotherapy response.

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程序性死亡配体1 （PDL1）在新辅助三阴性乳腺癌中的表达：与化疗反应和残留癌症负担的关系

程序性死亡配体1 （PDL1）在肿瘤中的表达与各种癌症的免疫逃避有关，使这些患者成为PDL1抑制剂的潜在候选者。尽管免疫检查点阻断疗法已被批准用于乳腺癌治疗，特别是三阴性乳腺癌（TNBC），但在巴基斯坦乳腺癌患者中缺乏PDL1表达数据。在我们的研究中，评估了TNBC中PDL1的表达，以确定PDL1抑制剂的资格。我们的研究旨在评估TNBC中PDL1的表达频率。我们还研究了PDL1表达与TNBC患者的临床病理特征和预后因素的关系。此外，还评估了新辅助化疗反应与PDL1表达的关系。方法横断面研究于2022年1月至2023年6月在Liaquat国立医院组织病理学科进行。在此期间，共有128例活检证实的tnbc患者在手术前接受了新辅助化疗。化疗前穿刺活检行PDL1免疫组化染色。采用联合阳性评分（CPS）测定表达。CPS为pdl1染色细胞（肿瘤细胞、淋巴细胞和巨噬细胞）的数量除以活的肿瘤细胞总数乘以100。CPS≥10视为pdl1阳性。结果32.8% （n = 42）的病例病理反应完全。18.8% （n = 24）的病例有PDL1表达。大多数病例显示高残留癌负担（RCB-III）（n = 53, 41.4%）。PDL1表达与新辅助化疗反应有显著相关性（p < 0.01）。pdl1阳性病例的pCR值（n = 16, 66.7%）高于pdl1阴性病例（n = 26, 25%）。pdl1阳性病例RCB-II- iii的频率（RCB-II: 8.3%; RCB-III: 0%）低于pdl1阴性病例（RCB-II: 25%; RCB-III: 51%）， p值显著（p < 0.01）。结论总体而言，在我们的研究中，TNBC病例中PDL1表达较低；然而，识别这些病例对于识别那些可以从免疫治疗中受益的病例很重要。我们发现PDL1表达与新辅助化疗反应和RCB显著相关。此外，PDL1阳性与较低的Ki67指数和年龄有关。因此，我们建议在所有TNBC病例中进行常规PDL1检测，以预测新辅助化疗的反应。

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来源期刊

Breast Journal 医学-妇产科学

CiteScore

4.00

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.