Why the study?
Most studies on PD-L1 in sarcoma have used small specimens and lack clear cutoff values for scoring, while ICIs remain unapproved for sarcomas despite showing satisfactory results in some patients.
Does PD-L1 immunoreactivity correlate with survival outcomes in patients with high-grade chondrosarcomas, abdominal liposarcomas, and undifferentiated pleomorphic sarcomas?
Does PD-L1 immunoreactivity correlate with survival outcomes in patients with high-grade chondrosarcomas, abdominal liposarcomas, and undifferentiated pleomorphic sarcomas?
PD-L1 expression varies across sarcoma subtypes but does not significantly correlate with metastasis-free or overall survival, though a subset with >50% expression may warrant investigation for targeted therapy.
PD-L1 expression in high-grade sarcomas lacks standardized cutoffs; larger studies needed before biomarker or therapeutic implications.
Immune checkpoint inhibitors (ICIs) such as PD1/PD-L1 blockers are an established treatment for many solid cancers. There are currently no approved ICIs for sarcomas, but satisfactory results have been seen in some patients with disseminated disease in certain histological types. Most studies on PD-L1 in sarcoma have used small specimens and there are no clear cutoff values for scoring. We investigated PD-L1 immunoreactivity in high-grade chondrosarcomas (CS), abdominal liposarcoma (LS) and undifferentiated pleomorphic sarcomas (UPS). In total, 230 tumors were stained with SP142 and SP263 assays and evaluated by two clinical pathologists. Immunoreactivity in tumor and immune cells was correlated with clinical outcome. Overall, ≥1% PD-L1 immunoreactivity in tumor cells was found in 11 CS, 26 LS and 59 UPS (SP142 assay) and in 10 CS, 26 LS and 77 UPS (SP263 assay). Most tumors exhibited ≤10% PD-L1 immunoreactivity, but a subset across all three subtypes had >50%. Kaplan-Meier survival analysis showed no significant difference in metastasis-free or overall survival in relation to PD-L1 immunoreactivity in tumor or immune cells for any subtype. As there is a lack of clinical data regarding PD-L1/PD-1 status and therapy response, it is not currently possible to establish clear cutoff values. Patients with high (>50%) PD-L1 immunoreactivity in tumor cells (TC) with the SP263 assay would be a logical group to investigate for potentially beneficial PD1/PD-L1-targeted treatment.
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Zhang et al. (2022) studied this question.
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