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Related Concept Videos

Tumor Immunotherapy01:27

Tumor Immunotherapy

Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.

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PD-L1 and Ki-67 Expression Before and After Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer.

Daichi Sasaki1, Tohru Yoneyama2, Fumiya Yoneyama1

  • 1Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

International Journal of Urology : Official Journal of the Japanese Urological Association
|May 23, 2025
PubMed
Summary

Neoadjuvant chemotherapy (NAC) significantly increases programmed cell death ligand 1 (PD-L1) expression and decreases Ki-67 labeling index in muscle-invasive bladder cancer (MIBC). Further research is needed to understand how gene expression changes impact prognosis.

Keywords:
Ki‐67PD‐L1bladder cancercystectomyprognosis

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Area of Science:

  • Oncology
  • Immunotherapy
  • Bladder Cancer Research

Background:

  • Programmed cell death ligand 1 (PD-L1) is a poor prognostic factor in muscle-invasive bladder cancer (MIBC).
  • Limited data exists on PD-L1 expression changes after neoadjuvant chemotherapy (NAC).

Purpose of the Study:

  • To investigate the longitudinal association between PD-L1 and Ki-67 expression before and after NAC in MIBC patients.
  • To explore differential gene expression changes post-NAC.

Main Methods:

  • Retrospective analysis of 104 MIBC patients undergoing platinum-based NAC and radical cystectomy.
  • Matched tumor specimens from transurethral resection (TURBT) and post-chemotherapy residual disease (RC) were analyzed.
  • Immunohistochemistry for PD-L1 and Ki-67, and gene expression profiling were performed.

Main Results:

  • PD-L1 positivity increased significantly post-NAC (15.4% to 28.8%).
  • Median Ki-67 labeling index significantly decreased post-NAC (30.6% to 9.9%).
  • Correlation between treatment effects and gene expression changes was difficult to ascertain.

Conclusions:

  • NAC significantly impacts PD-L1 expression and Ki-67 index in MIBC.
  • The prognostic significance of gene expression alterations post-NAC requires further investigation.