Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer
Objectives The study aimed to conduct an in-depth analysis of the influence of PD-L1 status and expression levels and other variables on the effectiveness of immune checkpoint inhibitors (ICIs) in treating breast cancer. Methods A total of 19 articles, involving 16 trials and 7899 patients, were inc...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-10-01
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| Series: | Cancer Control |
| Online Access: | https://doi.org/10.1177/10732748241299074 |
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| author | Shuangwei Mo MBBS Yuxian Wang MBBS Yaoling Wang MBBS Xinhai Chen MBBS Hongyi Zhu MBBS Zhengrong Zou MD Weikai Xiao MD |
| author_facet | Shuangwei Mo MBBS Yuxian Wang MBBS Yaoling Wang MBBS Xinhai Chen MBBS Hongyi Zhu MBBS Zhengrong Zou MD Weikai Xiao MD |
| author_sort | Shuangwei Mo MBBS |
| collection | DOAJ |
| description | Objectives The study aimed to conduct an in-depth analysis of the influence of PD-L1 status and expression levels and other variables on the effectiveness of immune checkpoint inhibitors (ICIs) in treating breast cancer. Methods A total of 19 articles, involving 16 trials and 7899 patients, were included in the analysis. The outcomes of interest were odds-ratio (OR) for pathological complete response (pCR) in early breast cancer, and hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) in advanced breast cancer. Results In early breast cancer, individuals with PD-L1-positive tumors were more likely to benefit from ICIs than those with PD-L1-negative tumors. Furthermore, patients with PD-L1 positivity in immune cells (IC) had superior outcomes compared to those scoring positively on combined positive score (CPS), with ORs for ICIs benefit being 2.28 for IC-positive patients vs 1.78 for CPS-positive patients. Regarding the impact of breast cancer subtypes on the efficacy of ICIs, our findings indicated that triple-negative breast cancer (TNBC) exhibits the greatest therapeutic response with OR of 1.93, followed by the hormone receptor-positive (HoR+) / human epidermal growth factor receptor 2-negative (HER2−), while the HER2+ was the worst. Additionally, age was identified as a key predictive factor in responding to ICIs. In advanced breast cancer, there was an upward trend in CPS values associated with enhanced ICIs responsiveness, with the predictive value increasing from 12% at a CPS threshold of 10 to 13.6% at 20. Conclusion The study concluded that the PD-L1 expression scoring system effectively discriminates between patients with breast cancer in terms of the degree of benefit they may attain from ICIs. Patients with little or no PD-L1 expression experienced a diminished therapeutic benefit from ICIs. |
| format | Article |
| id | doaj-art-21397a0d8a1f4077a4d6ae67c3820188 |
| institution | OA Journals |
| issn | 1526-2359 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cancer Control |
| spelling | doaj-art-21397a0d8a1f4077a4d6ae67c38201882025-08-20T02:32:44ZengSAGE PublishingCancer Control1526-23592024-10-013110.1177/10732748241299074Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast CancerShuangwei Mo MBBSYuxian Wang MBBSYaoling Wang MBBSXinhai Chen MBBSHongyi Zhu MBBSZhengrong Zou MDWeikai Xiao MDObjectives The study aimed to conduct an in-depth analysis of the influence of PD-L1 status and expression levels and other variables on the effectiveness of immune checkpoint inhibitors (ICIs) in treating breast cancer. Methods A total of 19 articles, involving 16 trials and 7899 patients, were included in the analysis. The outcomes of interest were odds-ratio (OR) for pathological complete response (pCR) in early breast cancer, and hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) in advanced breast cancer. Results In early breast cancer, individuals with PD-L1-positive tumors were more likely to benefit from ICIs than those with PD-L1-negative tumors. Furthermore, patients with PD-L1 positivity in immune cells (IC) had superior outcomes compared to those scoring positively on combined positive score (CPS), with ORs for ICIs benefit being 2.28 for IC-positive patients vs 1.78 for CPS-positive patients. Regarding the impact of breast cancer subtypes on the efficacy of ICIs, our findings indicated that triple-negative breast cancer (TNBC) exhibits the greatest therapeutic response with OR of 1.93, followed by the hormone receptor-positive (HoR+) / human epidermal growth factor receptor 2-negative (HER2−), while the HER2+ was the worst. Additionally, age was identified as a key predictive factor in responding to ICIs. In advanced breast cancer, there was an upward trend in CPS values associated with enhanced ICIs responsiveness, with the predictive value increasing from 12% at a CPS threshold of 10 to 13.6% at 20. Conclusion The study concluded that the PD-L1 expression scoring system effectively discriminates between patients with breast cancer in terms of the degree of benefit they may attain from ICIs. Patients with little or no PD-L1 expression experienced a diminished therapeutic benefit from ICIs.https://doi.org/10.1177/10732748241299074 |
| spellingShingle | Shuangwei Mo MBBS Yuxian Wang MBBS Yaoling Wang MBBS Xinhai Chen MBBS Hongyi Zhu MBBS Zhengrong Zou MD Weikai Xiao MD Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer Cancer Control |
| title | Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer |
| title_full | Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer |
| title_fullStr | Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer |
| title_full_unstemmed | Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer |
| title_short | Expanding the PD-L1 Paradigm: A Comprehensive Systematic Review and Meta-Analysis of Scoring Systems and Additional Biomarkers Influencing Immune Checkpoint Inhibitor Outcomes in Breast Cancer |
| title_sort | expanding the pd l1 paradigm a comprehensive systematic review and meta analysis of scoring systems and additional biomarkers influencing immune checkpoint inhibitor outcomes in breast cancer |
| url | https://doi.org/10.1177/10732748241299074 |
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