Negative influence of programmed death-1-ligands on the survival of esophageal cancer patients treated with chemotherapy

Abstract

The programmed death-1/programmed death-1ligands (PD-1/PD-Ls) pathway plays an important role in immunological tumor evasion. However, clinical significance of the PD-Ls (L1 and L2) expression in esophageal cancer treated with chemotherapy has not been fully investigated.

We examined the expression of PD-Ls of the primary tumors obtained from 180 esophageal cancer patients who underwent radical resection with or without neoadjuvant chemotherapy (NAC) using immunohistochemical staining. The relationship between the expression patterns and clinico-pathological characteristics were examined.

The 53 patients (29.4%) and 88 patients (48.3%) were classified into positive for PD-L1 and PD-L2 expression, respectively. In all the patients examined in this study, overall survival rates of the patients with tumors positive for PD-L1 or PD-L2 were significantly worse than those with tumors negative for PD-L1 or PD-L2 (p=0.0010 and p=0.0237, respectively). However, subgroup analysis showed that these tendencies are only found in the patients treated with NAC, but not in the ones without NAC. The patients with positive PD-L1 expression had significantly higher rate of NAC history (p=0.0139), but those with positive PD-L2 expression did not (p=0.6127). There is no significant relationship between PD-L1 expression and response to chemotherapy (p=0.3118), but the patient with positive PD-L2 expression had significantly inferior responses to chemotherapy (p=0.0034).

The PD-1/PD-Ls pathway might be an immunological mechanism associated with the long-term effectiveness of the chemotherapy in esophageal cancer patients. Further investigations on the roles of PD-1 pathway in chemotherapy would lead to the development of better treatments for this disease.

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