Expression and Prognostic Relevance of PD-1, PD-L1, and CTLA-4 Immune Checkpoints in Adrenocortical Carcinoma
Authors' conclusion
The heterogeneous expression of PD1, PD-L1, and CTLA-4 in this large series of well-annotated ACC samples might explain the heterogeneous results of the immunotherapies in advanced ACC. In addition, PD-1 expression is a strong prognostic biomarker that can easily be applied in routine clinical care and histopathological assessment.
Study context
- Population
- Patients with adrenocortical carcinoma (ACC); 162 tumor samples162 tumor samples
- Participants
- 122 patients
- Exposure
- PD-1, PD-L1 and CTLA-4 expression in ACC and their correlation with T-cell infiltration and clinical outcome
- Outcome
- Immune checkpoint expression in ACC samples
Methodological detailsimmunohistochemistry (threshold of >1%), univariate and multivariate survival analyses
- Immunohistochemistry (threshold of >1%)
- Univariate and multivariate survival analyses
Main finding
As reported in the abstract
- PD-1 expressed
- 26.5% of samples
- PD-L1 expressed
- 24.7% of samples
- PD-1 median positive cells
- 2.1%
- PD-L1 median positive cells
- 21.7%
- CTLA-4 expressed
- 52.5% of ACC
- CTLA-4 median positive cells
- 38.4%
Observational data: associations, not effects.
Further findings
| Outcome | HR for progression or death (95% CI) | P value | |
|---|---|---|---|
| Progression-free survival by PD-1 expressionPD-1 positivevs PD-1 negative | 0.50 (0.25–0.98) | P = 0.04 | |
| 0.20.5125HR for progression or death (log scale) |
- Progression-free survival by PD-1 expression: longer PFS with positive PD-1; even after considering prognostic factors
PD-L1 and CTLA-4 expression and clinical outcome
- PD-L1 and CTLA-4 did not correlate with clinical outcome
T-cell infiltration
- PD-1 and PD-L1 expression correlated significantly with CD3+, CD4+, FoxP3+ and CD8+ T cells
Original publication
Expression and Prognostic Relevance of PD-1, PD-L1, and CTLA-4 Immune Checkpoints in Adrenocortical Carcinoma. J Clin Endocrinol Metab. Published 28 February 2024. doi:10.
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