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Clinicopathological and Prognostic Value of Programmed Death Ligand-1 (PD-L1) In Breast Cancer: A Meta-Analysis

Qi Xue and Guochao Zhang

Background: The association of immunological checkpoint marker programmed death ligand-1 (PD-L1) and the prognosis of various malignancies has been widely observed, recently. However, the association between PD-L1 expression and breast cancer patients’ survival remains controversial. Thus, we performed this study to assess the clinical value of PD-L1.

Methods: We searched the electronic databases for eligible literature. Medline/PubMed, EMBASE, the Cochrane Library databases and Grey literature were searched up to 30 March 2016 for the association between PD-L1 expression and breast cancer prognosis. Hazard ratios (HRs) for overall survival (OS) with 95% confidence intervals (CIs) according to the expression status of PD-L1 were calculated from the included studies. Moreover, the odds ratio (OR) was also analyzed to evaluate the association between the clinicopathological parameters of participants and PD-L1 expression.

Results: 10 studies were included in the meta-analysis while 7 for clinical pathological features and PDL1. We found that elevated PD-L1 had no significant association with breast cancer patients’ survival. However, increased PD-L1 was found to be significantly associated with histological grade (OR=1.86, 95% CI: 1.38-2.51; P_{heterogenecity}=0.0196), ER (OR=0.36, 95% CI: 0.17-0.75; P_{heterogenecity}=0.000), PR (OR=0.31, 95% CI: 0.11-0.86; P_{heterogenecity}=0.000) in breast cancer.