PD-L1 expression in non-clear cell renal cell carcinoma.

Authors

Andre P. Fay

André P Fay

Dana-Farber Cancer Institute, Boston, MA

André P Fay , Marcella Callea , Kathryn P. Gray , Thai Huu Ho , Jiaxi Song , Ingrid Carvo , Megan E. Lampron , Melissa L. Stanton , David F. McDermott , Michael B. Atkins , Gordon J Freeman , Michelle S. Hirsch , Sabina Signoretti , Toni K. Choueiri

Organizations

Dana-Farber Cancer Institute, Boston, MA, Brigham and Women's Hospital, Boston, MA, Mayo Clinic, Scottsdale, AZ, Mayo Clinic, Phoenix, AZ, Beth Israel Deaconess Medical Center, Boston, MA, Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA

Research Funding

No funding sources reported

Background: Programmed death-1 (PD-1) receptor negatively regulates T cell-mediated responses.PD-1 ligand (PD-L1) is aberrantly expressed in clear cell renal cell carcinoma (ccRCC) and is associated with worse prognosis. Levels of PD-L1 expressions in non-ccRCC and its association with clinicopathological features and survival are unknown. Methods: Formalin-fixed paraffin-embedded (FFPE) specimens were obtained from 97 patients with chromophobe (CHR), papillary (PAP), translocation Xp11.2 (TrL) RCC and oncoytoma (ONC) and were included in the analysis. PD-L1 expression was evaluated by immunohistochemistry using a mouse monoclonal anti-PD-L1 antibody (405.9A11). The assay was validated using FFPE cell line controls known to be positive or negative for PD-L1 expression by flow cytometry. PD-L1 tumor positivity (PD-L1+) was defined as ≥5% tumor cell membrane staining. For PD-L1 expression in immune cells, a combined score based on the intensity of infiltrate and percentage of positive cells was used. Baseline characteristics including stage/grade, and survival data were collected. Comparisons between PD-L1 expression and clinicopathological features were evaluated using chisq or wilcoxon rank sum tests. Cox model tests for association of PD-L1 expression with OS in univariate and multivariable analysis. Results: Among 97 patients, 12 (12.4%) were considered PD-L1+ in tumor cells: 2/36 (5%) of CHR RCC, 5/50 (10%) of PAP RCC, 3/7 (43%) of TrL RCC, and 2/4 (50%) of ONC. PD-L1 positivity in tumor cells was significantly associated with higher stage (p=0.026) and grade (p=0.046), as well as lower OS on univariate (p=0.02) but not multivariate analysis (p=0.29). On the other hand, PD-L1 positivity by immune cells was observed in 50 (51.5%) patients: 13/36 (36%) of CHR RCC, 30/50 (60%) of PAP RCC, 6/7 (86%) of TrL RCC, and 1/4 (25%) of ONC. PD-L1 positivity in immune cells did not correlate with stage (p=0.7), grade (p=0.1) or OS (p=0.8). Conclusions: PD-L1 expression is variable in non-ccRCC and depends on histology and tumor vs. immune cells scoring. Only PD-L1 positivity in tumors cells was associated with aggressive features. Patients with non-ccRCC should not be automatically excluded from trials of agents that target the PD-1/PD-L1 pathway.

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Abstract Details

Meeting

2014 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session C: Renal Cancer

Track

Renal Cell Cancer

Sub Track

Renal Cell Cancer

Citation

J Clin Oncol 32, 2014 (suppl 4; abstr 424)

DOI

10.1200/jco.2014.32.4_suppl.424

Abstract #

424

Poster Bd #

C10

Abstract Disclosures

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