Abstract
Several ongoing clinical trials are investigating the use of immuno-targeting therapy with programmed cell death protein-1 and programmed death-ligand 1 (PD-L1) inhibitors for triple-negative breast cancer. However, the role of PD-L1 expression in HER2-positive breast cancer remains unclear. We investigated the clinicopathological utility of PD-L1 expression in HER2-positive breast cancer. Cohort A included 248 patients with invasive breast cancer (all subtypes). Cohort B included 126 HER2-positive patients who received neoadjuvant chemotherapy (NAC) concomitant with trastuzumab. The relationship of PD-L1 expression on the cancer cells with clinicopathological factors including pathological complete response (pCR) and prognosis was investigated. In cohort A, 8.1% patients were PD-L1-positive; PD-L1 positivity showed a correlation with high degree of tumor-infiltrating lymphocytes (TILs), estrogen receptor negativity, progesterone receptor negativity, and high histological grade. In cohort B, 17.5% patients were PD-L1-positive; PD-L1 positivity showed a significant correlation with high degree of TILs and high abundance of CD8-positive TILs. The pCR rates were related to TILs and PD-L1 expression. Among PD-L1-negative patients, high CD8-positive TILs were associated with significantly better prognosis. In conclusion, 17.5% of HER2-positive type patients were PD-L1-positive. PD-L1 expression was associated with response to NAC with trastuzumab in patients with HER2-positive breast cancer.
Highlights
Several ongoing clinical trials are investigating the use of immuno-targeting therapy with programmed cell death protein-1 and programmed death-ligand 1 (PD-L1) inhibitors for triple-negative breast cancer
On the basis of these guidelines, we previously found that tumor-infiltrating lymphocytes (TILs)-expression was a potent predictor of the response to neoadjuvant chemotherapy (NAC) with trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer[4]
PD-1 is expressed on the surface of lymphocytes, whereas its ligand PD-L1 is expressed on the surface of cancer cells as well as lymphocytes[8]
Summary
Several ongoing clinical trials are investigating the use of immuno-targeting therapy with programmed cell death protein-1 and programmed death-ligand 1 (PD-L1) inhibitors for triple-negative breast cancer. The degree of TIL is considered an important prognostic factor and a predictive factor for the treatment of breast cancer patients, especially those with estrogen receptor (ER)-negative type[3,4,5,6]. On the basis of these guidelines, we previously found that TIL-expression was a potent predictor of the response to neoadjuvant chemotherapy (NAC) with trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer[4]. The present study investigated the relationship of PD-L1 expression with several clinicopathological factors, including the outcome and pathological response to NAC with trastuzumab in patients with HER2-positive breast cancer
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