[Abstract]
Background The prognostic value of soluble programmed cell death ligand-1 (sPD-L1) in patients with cancer has been inconsistent across previous studies.
Objective This meta-analysis aimed to investigate the prognostic significance of sPD-L1 in human tumors.
Methods A comprehensive search of PubMed, Web of Science, Embase, and Cochrane databases from inception to January 6, 2020 was conducted. Studies of sPD-L1 measured by enzyme-linked immunosorbent assay (ELISA) that had available hazard ratios (HRs) for survival outcomes based on high or low sPD-L1 levels were included. The primary endpoint was long-term survival, namely, overall survival (OS), and the second endpoint was short-term survival, including progression- free survival (PFS), disease-free survival (DFS), recurrence-free survival (RFS), and cancer-specific survival (CSS).
Results A total of 21 studies, with 2413 patients, were included in this meta-analysis. Elevated sPD-L1 was associated with worse OS [HR=2.46, 95% confidence interval (CI) 1.74–3.49, P<0.001]. Moreover, high sPD-L1 was predictive of worse PFS/DFS/RFS/CSS (HR=2.22, 95% CI 1.47–3.35, P<0.001). High sPD-L1 was consistently correlated with poor OS and PFS/DFS/RFS/CSS irrespective of study design, sample, and cut-off value of sPD-L1. However, there was non-significant correlation between sPD-L1 and sex, age, clinical stage, Eastern Cooperative Oncology Group Performance Status, tumor differentiation, or serum lactate dehydrogenase.
Conclusions This meta-analysis showed that sPD-L1 was correlated with poor prognosis in human tumors. In addition, sPD-L1 could be used as a predictive factor of inferior outcomes during multiple malignancy treatments.
【中文摘要】
背景： 癌症患者體內可溶性細胞程序性死亡配體1（sPD-L1）的預後價值，在既往的不同研究中並不一致。
目的： 本項薈萃分析旨在研究人類腫瘤sPD-L1的預後意義。
方法 ：全面檢索截至2020年1月6日的PubMed、Web of Science、Embase和Cochrane資料庫。應用酶聯免疫吸附法（ELISA）檢測sPD-L1並具備基於高或低sPD-L1水平生存結果風險比的研究均予以納入。主要觀察終點為長期生存，即總生存期（OS），第二觀察終點為短期生存，包括無進展生存期（PFS）、無病生存期（DFS）、無復發生存期（RFS）和癌症特異性生存期（CSS）。
結果： 本項薈萃分析共納入21項研究，2413位患者。sPD-L1升高與OS縮短相關[HR=2.46，95％置信區間（CI）1.74-3.49，P<0.001]。此外，高sPD-L1水平可以預測PFS/DFS/RFS/CSS縮短（HR=2.22，95％CI 1.47-3.35，P<0.001）。高sPD-L1始終與OS和PFS/DFS/RFS/CSS縮短相關，且與研究設計、樣本量、sPD-L1臨界值無關。但sPD-L1與性別、年齡、臨床分期、ECOG體能狀態、腫瘤分化或血清乳酸脫氫酶之間並無顯著相關性。
結論： 本項薈萃分析顯示sPD-L1與人類腫瘤的不良預後相關。此外，在多種惡性腫瘤治療中，sPD-L1可以成為不良預後因子。