Recently, checkpoint inhibition of the PD-1/PD-L1 axis has been shown to be therapeutically relevant in urothelial carcinoma (UC). To evaluate the predictive and prognostic value of PD-L1 on response and survival in UC patients after cystectomy, chemotherapy, or anti-PD-1/PD-L1 therapy, a systematic review of PubMed, Embase, Web of Science, and the Cochrane Library was performed. A total of 2154 patients from 14 published studies were included. In all UC patients after cystectomy, tumour cell (TC) PD-L1 expression was not associated with the OS or PFS. For the subset of patients with organ-confined disease, TC PD-L1 expression significantly predicted OS after cystectomy (). There was no significant evidence of an association between TC PD-L1 status and ORR or OS for UC patients treated with platinum-based chemotherapy. For UC patients treated with anti-PD-1/PD-L1 therapy, TC PD-L1 could predict the response (), but not for the 1% cut-off (). As for PD-L1 expression in tumour-inflating immune cells (TIICs), both subsets with IC2/3 vs. IC0/1 and IC1/2/3 vs. IC0 were associated with ORR to anti-PD-1/PD-L1 therapy. In the TIIC subset, IC2/3 vs. IC0/1 of PD-L1 was associated with higher CR (), PR (), and PD (). Further, higher TIIC PD-L1 status benefited from longer PFS (), but was not associated with OS in UC patients with anti-PD-1/PD-L1 therapy. Our study suggested that TIIC PD-L1 expression with 5% cut-off was valuable as a predictive and prognostic biomarker for ORR and PFS in UC patients with anti-PD-1/PD-L1 therapy.

中文翻译：

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PD-L1在具有抗PD-1 / PD-L1治疗的尿道上皮癌患者中的预测和预后作用：系统评价和荟萃分析。

近来，已显示PD-1 / PD-L1轴的检查点抑制在尿路上皮癌（UC）中与治疗相关。为了评估PD-L1对膀胱切除术，化学疗法或抗PD-1 / PD-L1治疗后UC患者的反应和生存的预测和预后价值，对PubMed，Embase，Web of Science和Cochrane进行了系统评价已执行图书馆。包括来自14个已发表研究的2154例患者。在所有膀胱切除术后的UC患者中，肿瘤细胞（TC）PD-L1的表达与OS或PFS无关。对于器官受限疾病患者的子集，TC PD-L1表达显着预测了膀胱切除术后的OS（）。没有明显的证据表明TC PD-L1状态与接受铂类化学疗法治疗的UC患者的ORR或OS之间存在关联。对于使用抗PD-1 / PD-L1治疗的UC患者，TC PD-L1 可以预测响应（），但不适用于1％的截止（）。至于PD-L1在膨胀性免疫细胞（TIIC）中的表达，IC2 / 3与IC0 / 1和IC1 / 2/3与IC0的两个亚群均与抗PD-1 / PD-L1的ORR相关治疗。在TIIC子集中，PD-L1的IC2 / 3与IC0 / 1与较高的CR相关（）， PR（）和PD（）。此外，更高的TIIC PD-L1状态得益于更长的PFS（），但与抗PD-1 / PD-L1治疗的UC患者的OS无关。我们的研究表明，在抗PD-1 / PD-L1治疗的UC患者中，TIIC PD-L1的5％截止表达可作为ORR和PFS的预测和预后生物标志物。