Clinical implication of PD-L2 in the prognosis assessment of HNSCC immunotherapy

doi:10.19401/j.cnki.1007-3639.2023.06.009

Abstract

Abstract:

Background and purpose: Programmed death-1 (PD-1) monoclonal antibody therapy plays an increasingly important role in the treatment of head and neck squamous cell carcinoma (HNSCC). However, low response rate and lack of predictive biomarkers are still the challenging problems. This study aimed to confirm that programmed death ligand-2 (PD-L2) is a predictive biomarker for the outcome of HNSCC anti-PD-1 immunotherapy. Methods: The samples and clinical data of 50 HNSCC patients undergoing PD-1 monoclonal antibody immunotherapy were collected. Immunohistochemical staining was used to analyze the level of programmed death ligand-1 (PD-L1) and PD-L2. Kaplan-Meier overall survivals were analyzed using SPSS 26.0 software, grouped by the basic clinical characteristics and the PD-L1 and PD-L2 levels. Survival curves were plotted using GraphPad Prism. Results: HNSCC had a relatively high expression rate of PD-L2 with more than 80% of cases detected as PD-L2 positive. The expression of PD-L2 significantly correlated with the clinical outcome of immunotherapy, with a mean survival of 18.8 (16.0-21.7) months for patients with high PD-L2 expression and 11.0 (9.1-12.8) months for patients with low PD-L2 expression, this difference being statistically significant. Conclusion: PD-L2 has the potential to be used as a predictive biomarker for HNSCC anti-PD-1 immunotherapy.

Key words: Head and neck squamous cell carcinoma, Immunotherapy, Programmed death ligand-2

CLC Number:

R739.91

HUANG He, JU Houyu, YANG Wenyi, YAN Ming, REN Guoxin, HU Jingzhou. Clinical implication of PD-L2 in the prognosis assessment of HNSCC immunotherapy[J]. China Oncology, 2023, 33(6): 613-618.

Figures/Tables 6

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References 13

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Basic clinical characteristics	Case n (%)
Gender
Male	35 (70.00)
Female	15 (30.00)
Primary site
Oral cavity and mucosal lip	43 (86.00)
Body of tongue	18 (41.86)
Buccal mucosa	9 (20.93)
Lower gingiva	6 (13.95)
Mouth floor	4 (9.30)
Upper gingiva and hard palate	4 (9.30)
Upper lip	1 (2.33)
Lower lip	1 (2.33)
Oropharynx and hypopharynx	6 (12.00)
Parotid gland	1 (2.00)
AJCC staging
Ⅲ	2 (4.00)
Ⅳa	6 (12.00)
Ⅳb	31 (62.00)
Ⅳc	11 (22.00)
Recurrent disease
Yes	47 (94.00)
No	3 (6.00)
Regional lymph node metastasis
Yes	32 (64.00)
No	18 (36.00)
Distal metastasis
Yes	11 (22.00)
No	39 (78.00)

Medical history, laboratory test, and treatment	Case n (%)
Previous history of radiotherapy
Yes	34 (68.00)
No	16 (32.00)
CPS test before treatment
Yes	45 (90.00)
CPS≥1	43 (95.56)
CPS<1	2 (4.44)
No	5 (10.00)
Combined treatment
Combined chemotherapy only	33 (66.00)
Combined target therapy only	11 (22.00)
Combined both chemotherapy and target therapy	3 (6.00)
No combined treatment	3 (6.00)

Characteristics	Case n	Mean OS t/month	P value
Gender			0.234
Male	35	13.03 ± 1.23
Female	15	16.30 ± 1.96
Age/year			0.878
≥58	26	14.35 ± 1.29
<58	24	14.53 ± 1.79
Regional lymph node metastasis			0.336
Yes	32	13.83 ± 1.35
No	18	15.24 ± 1.70
Distal metastasis			0.657
Yes	11	12.22 ± 1.97
No	39	14.84 ± 1.29
Previous history of radiotherapy			0.931
Yes	34	13.88 ± 1.11
No	16	14.32 ± 2.25

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