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Multicenter Study
. 2024 Aug 27;14(1):19794.
doi: 10.1038/s41598-024-70779-8.

PD-L1 expression as a predictive biomarker in patients with recurrent or metastatic salivary gland carcinoma treated with pembrolizumab

Takashi Matsuki  1   2 , Daisuke Kawakita  3 , Hideaki Takahashi  4 , Takuro Okada  5 , Akihiro Sakai  6 , Yushi Ueki  7 , Hiroshi Tsuge  3 , Kenji Hanyu  5 , Kaho Momiyama  2 , Ryusuke Shodo  7 , Mayu Yamauchi  6   8 , Yukiko Asako  2   8 , Hideaki Hirai  9 , Toshitaka Nagao  9 , Yuichiro Tada  10
Affiliations
Multicenter Study

PD-L1 expression as a predictive biomarker in patients with recurrent or metastatic salivary gland carcinoma treated with pembrolizumab

Takashi Matsuki et al. Sci Rep. .

Abstract

Although immune checkpoint inhibitors (ICIs) are effective in some patients with salivary gland carcinoma (SGC), biomarkers which predict the efficacy and prognosis of SGC patients treated with pembrolizumab have not been identified. We conducted a multi-institutional retrospective cohort study to evaluate the efficacy and safety of pembrolizumab monotherapy in patients with recurrent and/or metastatic SGC and to determine optimal cut-off values of the combined positive score (CPS) and tumor proportion score (TPS) as numerical expression levels of programmed death-ligand 1 (PD-L1), which predict the efficacy of pembrolizumab. Furthermore, we investigated the association of patient characteristics and hematological markers with clinical outcomes, including overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). From 2016 to 2021, 27 patients were included in the analysis. ORR of SGC was 25.9%. Optimal cut-off values of CPS and TPS were 15 and 25%, respectively. ORRs of CPS-high and TPS-high were 55.6 and 75.0%, respectively, and significantly higher than those of CPS-low and TPS-low. Furthermore, patients with a low platelet-lymphocyte ratio (PLR) had a significantly longer PFS. No grade 4 or greater adverse events were observed. This study demonstrated the efficacy and safety of pembrolizumab monotherapy and identified optimal cut-off values of CPS and TPS.

Keywords: Combined positive score; Immune checkpoint inhibitors; Pembrolizumab; Programmed death-ligand 1; Salivary gland carcinoma; Tumor proportion score.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig.1
Fig.1
Kaplan–Meier survival curves of progression-free survival (a) and overall survival (b) of all patients. Vertical lines show censored events, and the shaded regions represent 95% CIs.
Fig.2
Fig.2
Representative images of the tumor before and during pembrolizumab monotherapy in a patient with pancreatic metastasis of salivary duct carcinoma. (a) Pre-treatment of the patient with pancreatic metastasis. (b) Tumor shrinkage observed 63 days after the initiation of pembrolizumab monotherapy. (c) Tumor disappeared 154 days after the initiation of pembrolizumab monotherapy.
Fig.3
Fig.3
Kaplan–Meier survival curves of SGC patients according to CPS (a) and TPS (b) on PFS. Vertical lines show censored events.
See this image and copyright information in PMC

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