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PD‐L1 Expression is Associated with Deficient Mismatch Repair and Poor Prognosis in Middle Eastern Colorectal Cancers
Author(s) -
AlKuraya Khawla,
Siraj Abdul,
Parvathareddy Sandeep Kumar,
Annaiyappanaidu Padmanaban,
Haqawi Wael,
AlRasheed Maha
Publication year - 2021
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2021.35.s1.03426
Subject(s) - medicine , colorectal cancer , immunohistochemistry , oncology , pathological , dna mismatch repair , biomarker , histology , cancer , biology , biochemistry
Several clinical trials are investigating the use of immune‐targeted therapy with Programmed death ligand‐1 (PD‐L1) inhibitors for colorectal cancer (CRC), with promising results for patients with mismatch repair (MMR) deficiency or metastatic CRC. However, the prognostic significance of PD‐L1 expression in CRC is controversial and such data is lacking in CRC from Middle Eastern ethnicity. We carried out this large retrospective study to investigate the prognostic and clinico‐pathological impact of PD‐L1 expression in 1148 Middle Eastern CRC using immunohistochemistry. High PD‐L1 expression was noted in 37.3% (428/1148) cases and correlated with aggressive clinico‐pathological features such as high‐grade (p < 0.0001), larger tumor size (p = 0.0007) and mucinous histology (p = 0.0005). Interestingly, PD‐L1 expression was significantly higher in patients exhibiting MMR deficiency (p = 0.0169) and BRAF mutation (p = 0.0008). Furthermore, the expression of PD‐L1 was found to be an independent marker for overall survival (HR=1.45; 95% CI=1.06–1.99; p=0.0200). In conclusion, the results of this study indicate that PD‐L1 expression could be a valid biomarker for poor prognosis in Middle Eastern CRC patients. This information can help in decision‐making for anti‐PD‐L1 therapy in Middle Eastern CRC, especially for patients with MMR deficient tumors.