Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2022) 81 P385 | DOI: 10.1530/endoabs.81.P385

ECE2022 Poster Presentations Endocrine-Related Cancer (41 abstracts)

PD-1 and PD-L1 immune checkpoint expression - the prognostic impact on adrenocortical carcinoma

Laura-Sophie Landwehr 1 , Iuliu Sbiera 1 , Barbara Altieri 1 , Hanna Remde 1 , Stefan Kircher 2 , Silviu Sbiera 1,3 , Matthias Kroiss 1,3,4 & Martin Fassnacht 1,3,5

1University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetes,; 2University Würzburg, Institute of Pathology; 3University of Würzburg, Comprehensive Cancer Center Mainfranken; 4LMU Klinikum München, Medizinische Klinik und Poliklinik IV; 5University Hospital Würzburg, Clinical Chemistry and Laboratory Medicine

Adrenocortical carcinoma (ACC) is a very severe endocrine malignancy with poor prognosis. While cancer immunotherapies have revolutionized the treatment of several cancer entities, the results of initial studies of different immune checkpoint inhibitors in ACC were heterogeneous and clinically substantial responses were observed only in a subset of patients. Expression of immune checkpoint molecules - programmed cell death 1 (PD-1) and its ligand PD-L1 - has been shown to predict response in different, but not all cancer entities. Using immunohistochemistry, a cohort of 129 ACCs was examined for PD-1 and PD-L1 expression. PD-1 and PD-L1 were present (threshold of ≥1% of cells) in 17.4% and 24.4% of samples, respectively, but expression was heterogeneous and in general rather low (median 3.9% (range 1-15) and 19.7% (range 1-90)). Interestingly, PD-1 expression was significantly associated with beneficial progression-free (HR: 0.30, 95% CI 0.13-0.72) and overall survival (HR: 0.21, 95% CI 0.53-0.84) independently of established prognostic factors, including ENSAT tumor stage, resection status, Ki67 proliferation index and glucocorticoid excess. In contrast, its ligand PD-L1 was not associated with clinical outcome in this ACC cohort. In addition, we analyzed the correlation of PD-1 and PD-L1 with tumor-infiltrating lymphocytes. Whereas PD-L1 correlated significantly with the number of CD3+ -, CD8+ -, and FoxP3+ T cells (P=0.0003, < 0.0001 and < 0.0001, respectively), PD-1 correlated only with FoxP3+ T cells (P=0.020). When including both PD-1 and different T cell subtypes in the above-mentioned multivariate Cox regression, the presence of PD1+ cells was the strongest predictor of favorable clinical outcome. In conclusion, this study provides several potential explanations for the heterogeneous results of the immune checkpoint therapy in advanced ACC. In addition, PD-1 expression serves as a strong prognostic biomarker that can easily be applied in routine clinical care as part of histo-pathological assessment.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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