title: PD-L1 expression in tonsillar cancer is associated with human papillomavirus positivity and improved survival: implications for anti-PD1 clinical trials.
abstract: In this study, we examined PD-L1 expression by immunohistochemistry in 99 patients with tonsillar cancer and known human papillomavirus (HPV) status to assess its clinical significance. We showed that the pattern of PD-L1 expression is strongly related to HPV status. The PD-L1 positivity rate was 83.3% in HPV-positive cases and 56.9% in HPV-negative cases (p < 0.05). Patients with HPV-positive/PD-L1-positive cancer had significantly better event free survival and overall survival compared with patients with HPV-negative/PD-L1-negative cancer. Relative to those patients with HPV-negative/PD-L1-negative disease who had the highest risk of death, patients with HPV-positive/PD-L1-positive cancers had a 2.85 fold lower risk of developing an event (HR 0.35, 95% CI: 0.16-0.79) and a 4.5 fold lower risk of death (HR =0.22, 95% CI: 0.09-0.53). Our findings will help to guide future clinical trial design in immunotherapy based on PD-L1 expression in tonsillar cancer.
authors: Sydney Medical School, The University of Sydney, NSW, Australia.
authors: Angela M
authors: AM
authors: Hong
authors: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.|Pathology North (Hunter), John Hunter Hospital, Newcastle, NSW, Australia.
authors: Ricardo E
authors: RE
authors: Vilain
authors: School of Mathematics and Statistics, The University of Sydney, NSW, Australia.
authors: Sarah
authors: S
authors: Romanes
authors: School of Mathematics and Statistics, The University of Sydney, NSW, Australia.
authors: Jean
authors: J
authors: Yang
authors: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.
authors: Elizabeth
authors: E
authors: Smith
authors: Sydney Medical School, The University of Sydney, NSW, Australia.
authors: Deanna
authors: D
authors: Jones
authors: Sydney Medical School, The University of Sydney, NSW, Australia.|Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.
authors: Richard A
authors: RA
authors: Scolyer
authors: Sydney Medical School, The University of Sydney, NSW, Australia.|Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.|Discipline of Pathology, School of Medicine, Western Sydney University, NSW, Australia.
authors: C Soon
authors: CS
authors: Lee
authors: Sydney Medical School, The University of Sydney, NSW, Australia.
authors: Mei
authors: M
authors: Zhang
authors: Sydney Medical School, The University of Sydney, NSW, Australia.
authors: Barbara
authors: B
authors: Rose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060890:B7-H1 Antigen / Q000378:metabolism*; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D012907:Smoking / Q000378:metabolism; D016019:Survival Analysis; D014067:Tonsillar Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000821:virology*
chemical_list: D060890:B7-H1 Antigen; C423236:CD274 protein, human
keywords: PD-L1; human papillomavirus; oropharyngeal cancer; p16; tonsillar cancer