在早期乳腺癌中,编程死亡连接体1 (PD-L1) 蛋白质表达中的内瘤空间异质性
Adriana Matutino Kahn1, Reza Golestani2, Malini Harigopal2
1Section of Medical Oncology, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Breast cancer research and treatment
|June 28, 2023
概括
在乳腺癌中,编程死亡连接体1 (PD-L1) 表达的空间异质性存在. 这种变化意味着单次活检可能会错过PD-L1阳性瘤,影响免疫治疗决策.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 生物标志物研究 生物标志物研究
背景情况:
- 编程死亡配体1 (PD-L1) 表达是对免疫检查点抑制剂反应的关键生物标志物,特别是在转移性三阴性乳腺癌 (TNBC) 中.
- 然而,PD-L1表达状态可以在瘤内发生变化,这对通过活检进行准确评估提出了挑战.
研究的目的:
- 在原发性乳腺瘤中研究PD-L1蛋白表达的空间异质性.
- 为了确定焦点PD-L1表达是否可以通过标准活检方法在II-III阶段的乳腺癌中错过.
主要方法:
- 分析PD-L1表达的瘤内部空间异质性,使用来自57个原发性乳腺瘤的多次活检 (33个TNBC,19个ER阳性,5个HER2阳性).
- PD-L1评估使用了E1L3N抗体和通过综合阳性评分 (CPS ≥10) 进行评分.
主要成果:
- 19%的所有瘤和27%的TNBC是PD-L1阳性,基于至少一个活检.
- 观察到显著的不一致率 (总体为16%,TNBC为23%),表明不同瘤区域之间的PD-L1状态的变化.
- 82%的PD-L1阳性病例仅在一个评估的活检样本中呈阳性,突出显示了瘤内部异质性的影响.
结论:
- PD-L1表达的内异质性是乳腺癌的一个重要因素.
- 由于这种异质性,当前的活检方法可能无法可靠地捕捉PD-L1阳性,这可能会影响免疫疗法治疗选择.
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