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PD-L1 Expression in Unresectable Locally Advanced or Metastatic Skin Squamous Cell Carcinoma Treated with

Stefano Cavalieri1, Federica Perrone2, Massimo Milione2

  • 1Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

Oncology
|May 22, 2019
PubMed
Abstract

Insights

PD-L1 expression in the tumor microenvironment was linked to longer progression-free survival in patients with advanced skin squamous cell carcinoma treated with EGFR inhibitors. This suggests a potential biomarker for treatment response.

Area of Science:

  • Oncology
  • Immunology
  • Dermatology

Background:

  • Advanced skin squamous cell carcinoma (sSCC) often requires systemic therapy when surgery or irradiation are not options.
  • Epidermal growth factor receptor (EGFR) inhibitors and immune checkpoint blockers (ICBs) have demonstrated efficacy in R/M sSCC.
  • The predictive role of PD-L1 expression in response to anti-EGFR agents in sSCC remains to be fully elucidated.

Purpose of the Study:

  • To investigate the association between PD-L1 expression and treatment outcomes in patients with R/M sSCC receiving EGFR inhibitors.
  • To explore the prognostic significance of PD-L1 expression on tumor cells (TCs) and tumor-infiltrating lymphocytes (ICs).

Main Methods:

  • Retrospective analysis of 28 R/M sSCC patients treated with dacomitinib or chemotherapy plus cetuximab (2010-2016).
  • PD-L1 expression assessed via immunohistochemistry on TCs and ICs.
  • Correlation of PD-L1 status with progression-free survival (PFS), overall survival (OS), and response rates.

Main Results:

  • PD-L1 expression on ICs was associated with significantly longer PFS (7.5 months vs. 2.1 months, p=0.02).
  • No significant correlation was found between PD-L1 expression (TC or IC) and OS or response rates.
  • A minority of cases (15%) showed positivity for both TC and IC PD-L1 expression.

Conclusions:

  • PD-L1 expression in the tumor microenvironment (ICs) may serve as a predictive biomarker for improved PFS in R/M sSCC treated with EGFR inhibitors.
  • Further research into the interplay between EGFR and PD-1/PD-L1 pathways, potentially through combination therapies, is warranted.
Keywords:
Anti-epidermal growth factor receptor treatmentEpidermal growth factor receptorOutcomePD-L1Skin squamous cell carcinoma

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