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Prevalence of PD-L1 expression is associated with EMAST, density of peritumoral T-cells and recurrence-free survival in operable non-metastatic colorectal cancer.


ABSTRACT: INTRODUCTION:Microsatellite instability (MSI) predict response to anti-PD1 immunotherapy in colorectal cancer (CRC). CRCs with MSI have higher infiltration of immune cells related to a better survival. Elevated Microsatellite Alterations at Tetranucleotides (EMAST) is a form of MSI but its association with PD-L1 expression and immune-cell infiltration is not known. METHODS:A consecutive, observational cohort of patients undergoing surgery for CRC. EMAST and clinicopathological characteristics were investigated against PD-L1, as well as CD3 and CD8 expression in the invasive margin or tumour centre (Immunoscore). Difference in survival between groups was assessed by log rank test. RESULTS:A total of 149 stage I-III CRCs patients, with a median follow up of 60.1 months. Patients with PD-L1+?tumours (7%) were older (median 79 vs 71 years, p?=?0.045) and had EMAST+?cancers (OR 10.7, 95% CI 2.2-51.4, p?=?0.001). Recurrence-free survival was longer in cancers with PD-L1+?immune cells (HR 0.35, 95% CI 0.16-0.76, p?=?0.008, independent of EMAST) and high Immunoscore (HR 0.10, 95% CI 0.01-0.72, p?=?0.022). Patients expressing PD-L1 in immune cells had longer disease-specific survival (HR 0.28, 95% CI 0.10-0.77, p?=?0.014). CONCLUSIONS:Higher Immunoscore (CD3/CD8 cells) and expression of tumour PD-L1 is found in CRCs with EMAST. Lymphocytic infiltrate and peritumoral PD-L1 expression have prognostic value in CRC.

PROVIDER: S-EPMC7347699 | BioStudies |

REPOSITORIES: biostudies

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