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PD-L1 expression, CD8+ T-cell counts associated with shorter OS in mRCC
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Higher levels of PD-L1 expression, as well as PD-L1 expression plus tumor CD8+ T-cell counts, were linked to shorter survival in patients with metastatic renal cell carcinoma who received VEGF-targeted therapy, according to results from a randomized controlled trial.
Poor outcomes in metastatic renal cell carcinoma (mRCC) have been associated with PD-L1 expression; however, this correlation has not been evaluated in patients with advanced RCC who receive VEGF-targeted agents.
Toni K. Choueiri
Toni K. Choueiri, MD, of the medical oncology department at Dana-Farber Cancer Institute, and colleagues analyzed PD-L1 tumor expression and CD8+ T cells in patients with advanced RCC treated with sunitinib (Sutent, Pfizer) or pazopanib (Votrient, GlaxoSmithKline).
Specimens were collected at baseline from patients enrolled in the COMPARZ trial.
Researchers used dual PD-LI/CD68 staining to distinguish PD-L1 tumor expression from tumor-associate microphages. Researchers used the log-rank test to evaluate relationships between biomarkers and survival.
Choueiri and colleagues analyzed available H-score data from 453 of 1,110 patients. Sixty-four percent of patients demonstrated negative PD-L1 expression (H-score = 0).
Patients with H-scores >55 (n=59, 13%) demonstrated shorter OS than patients with H-scores of ≤55 in the pazopanib arm (15.1 months vs. 35.6 months) and sunitinib arm (15.3 months vs. 27.8 months; P=.03).
Median OS in both arms was shortest in patients with H-scores >55 and intratumor CD8+ T-cell counts >300. Median OS for patients with H-scores >55 and intratumor CD8+ T-cell counts >300 was 9.6 months in the pazopanib arm and 11.9 months in the sunitinib arm.
Median OS in patients with H-scores ≤55 and CD8+ T-cell counts ≤300 was 36.8 months with pazopanib vs. 28 months with sunitinib.
PFS results were comparable to OS results.
“These findings may have implications for future design of randomized clinical trials in advanced RCC,” Choueiri and colleagues wrote.
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.
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