To do this study, the authors created 448 microarrays from patients in the International UTUC collaboration who underwent extirpative surgery for high-grade UTUC. These microarrays were then stained for PD-1 and PD-L1 expression and correlated with oncologic outcomes. PD-L1 and PD-1 were positive in 24% and 38% of patients, respectively. PD-L1 positivity was not significantly associated with survival outcomes. However, on Cox regression univariate modelling, PD-1 positivity was associated with worse recurrence-free survival (RFS) (HR 1.5, 95%CI 1.08-2.14), cancer-specific survival (CSS) (HR 1.5, 95%CI 1.07-2.19), and overall survival (OS) (HR 1.5, 95%CI 1.10-1.97). On Cox regression multivariate modelling, PD-1 positivity was no longer found to be an independent predictor of RFS, CSS or OS. A strength of this study is the large sample size allowing appropriate survival analysis for this relatively rare tumor entity.
In summary, the authors have identified PD-1 positivity associations with adverse pathological criteria and as a significant prognosticator for RFS, CSS and OS on univariate analysis in patients treated with extirpative surgery for high-grade UTUC in a large, multi-institutional cohort. This is exciting research potentially demonstrating feasibility of immunotherapy in the neo-/adjuvant and metastatic setting for UTUC.
Presented by: Laura-Maria Krabbe, UT Southwestern Medical Center, Dallas, TX, USA
Co-Authors: Barabara Heitzplatz, Ryan Hutchinson, Solomon Woldu, Nirmish Singla, Sina Preuss, Martin Boegemann, Christopher Wood, Jose Karam, Alon Weizer, Jay Raman, Mesut Remzi, Nathalie Rioux-Leclercq, Andrea Haitel, Marco Roscigno, Christian Bolenz, Karim Bensalah, Arthur Sagalowsky, Shahrokh Shariat, Yair Lotan, Evanguelos Xylinas, Vitaly Margulis
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA