Abstract
To investigate the role of PD-L1 expression in tumor recurrence and metastasis in Chinese patients with breast cancer. Suitable tissue samples were available from 870 patients with breast cancer. Paraffin-embedded tumor sections were stained with PD-L1 antibody. The correlations between PD-L1 expression and clinical characteristics, ER/PR/HER2 status and survival parameters were analyzed. Kaplan-Meier and univariate Cox proportional hazards model analyses were used to compare the survival of patients with high PD-L1 expression and patients with no PD-L1 expression. The median follow-up time was 98 months(range, 17-265 months).The positive rate of PD-L1 expression in breast cancer was 21.7% (189/870). PD-L1 high expression was inversely associated with larger tumor size, higher tumor grade, more positive lymph node number, as well as negative ER and PR status. PD-L1 expression was particularly higher in TNBC compared with non-TNBC, although no statistical significance was observed. Nomogram logistic regression results based on clinical and pathological features showed that the following factors were more likely associated with high PD-L1 expression: patient age younger than 35 years, larger tumor size, lymphovascular invasion and advanced stage. Our data indicated that patients with high PD-L1 expression had poor DFS, DMFS and overall survival compared with those with no PD-L1 expression. Univariate Cox proportional hazards model analysis showed that PD-L1 was an independent prognostic factor for tumor prognosis. PD-L1 expression is an important indicator of unfavorable prognosis in breast cancer patients.
Highlights
Breast cancer is currently the second leading cause of tumor-related death for females worldwide [1]
PD-L1 expression is an important indicator of unfavorable prognosis in breast cancer patients
This study aimed to explore the role of PD-L1 expression in the prognosis of870 Eastern Asian breast cancer patients
Summary
Breast cancer is currently the second leading cause of tumor-related death for females worldwide [1]. Despite the development of treatments for breast cancer, more than 50% of invasive breast cancer patients have developed distant metastases within ten years, causing treatment failure [2]. In recent years, immune therapy has become an emerging effective treatment for several cancers. Extended adjuvant endocrine therapy was shown to benefit patients with hormone receptor-positive breast cancer in the large sample size randomized ATLAS study [3]. The recurrence of breast cancer www.impactjournals.com/oncotarget remained high in realistic clinical practice. Finding an effective biomarker to select patients with breast cancer who are at a high risk for tumor recurrence or metastasis is an urgent task. To investigate the role of PD-L1 expression in tumor recurrence and metastasis in Chinese patients with breast cancer
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