Programmed death-ligand expression and lymph node involvement in penile squamous cell carcinoma

Submitted: July 25, 2024
Accepted: August 29, 2024
Published: October 2, 2024
Abstract Views: 588
PDF: 140
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Purpose: Our objective was to investigate the association between programmed death-ligand (PD-L1) immunoexpression measured as a combined positive score and clinical outcomes in penile SqCC.
Materials and methods: We retrospectively reviewed all penile SqCC cases diagnosed in our institution between 2018 and 2023. PD-L1 immunohistochemistry was performed as a qualitative assay. Immunoexpression in both tumor and immune cells equal or superior to 1 was considered positive.
Results: A total of 34 patients with conventional penile SqCC were included. Eleven cases were HPV-associated (32.4%). Twelve cases were PD-L1 CPS < 1 and twenty-two were PD-L1 CPS ≥ 1. Nine cases (32.4%) were PD-L1 CPS ≥ 1 and p16 positive, but this did not translate in worse clinicopathological features. Larger tumors (3.0 cm in PD-L1 CPS ≥ 1 vs 2.5 cm in PD-L1 CPS < 1; p = 0.662), vascular invasion (36.4% in PD-L1 CPS ≥ 1 vs. 25.0% in PD-L1 CPS < 1; p = 0.705) and perineural invasion (40.9% in PD-L1 CPS≥1 vs. 16.7% in PD-L1 CPS < 1; p = 0.252) were associated with PD-L1 expression. Among the high-risk features, only lymph node involvement had statistical significance, with 14 out of 22 PD-L1 CPS ≥ 1 patients (63.6%) having lymph node metastases when lymphadenectomy was performed (p = 0.031). With a median follow-up of 16 months (IQR 27.5), PD-L1 CPS ≥ 1 patients had worse overall survival (53.4 months vs 75.9 months), but no statistical significance could be inferred (p = 0.188).
Conclusions: It is noteworthy the clinical significance of lymph node involvement in PD-L1 CPS ≥ 1 cases and a trend towards worse overall survival in this group of patients.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

EAU Guidelines (2024). Edn. presented at the EAU Annual Congress Paris 2024.
Bleeker MCG, Heideman DAM, Snijders PJF, et al. Penile cancer: epidemiology, pathogenesis and prevention. World J Urol 2009;27:141-150. DOI: https://doi.org/10.1007/s00345-008-0302-z
Backes DM, Kurman RJ, Pimenta JM, Smith JS. Systematic review of human papillomavirus prevalence in invasive penile cancer. Cancer Causes Control 2009;20:449-457. DOI: https://doi.org/10.1007/s10552-008-9276-9
Brouwer OR, Rumble RB, Ayres B, et al. Penile Cancer: EAUASCO Collaborative Guidelines Update Q and A. JCO Oncol Pract 2024;20:33-37. DOI: https://doi.org/10.1200/OP.23.00585
Topalian SL, Hodi FS, Brahmer JR, et al. Safety, Activity, and Immune Correlates of Anti-PD-1 Antibody in Cancer. N Engl J Med 2012;366:2443-2454. DOI: https://doi.org/10.1056/NEJMoa1200690
Brahmer JR, Tykodi SS, Chow LQM, et al. Safety and Activity of Anti-PD-L1 Antibody in Patients with Advanced Cancer. N Engl J Med 2012;366:2455-2465. DOI: https://doi.org/10.1056/NEJMoa1200694
El-Mouallem N, Paul AK. Immune Checkpoint Inhibitors for Urothelial Cancer: An Update on New Therapies. Fed Pract 2018;35:S62.
Davidsson S, Carlsson J, Giunchi F, et al. PD-L1 Expression in Men with Penile Cancer and its Association with Clinical Outcomes. Eur Urol Oncol 2119; 2:214-221. DOI: https://doi.org/10.1016/j.euo.2018.07.010
U Udager AM, Liu TY, Skala SL, et al. Frequent PD-L1 expression in primary and metastatic penile squamous cell carcinoma: potential opportunities for immunotherapeutic approaches. Ann Oncol. 2016;27:1706-12. DOI: https://doi.org/10.1093/annonc/mdw216
Bacco MW De, Carvalhal GF, MacGregor B, et al. PD-L1 and p16 Expression in Penile Squamous Cell Carcinoma From an
Endemic Region. Clin Genitourin Cancer 2020;18:e254-e259. DOI: https://doi.org/10.1016/j.clgc.2019.10.014

How to Cite

Peyroteo, I., Santos, F., Marialva, C., & Brito Ramos, R. (2024). Programmed death-ligand expression and lymph node involvement in penile squamous cell carcinoma. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12856