The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases
Abstract Background Merkel cell carcinoma (MCC) comprises a rare malignant primary skin tumor presenting neuroendocrine differentiation. Recently, agents blocking the programmed cell death protein 1 and programmed cell death protein ligand 1 pathway (PD-1/PD-L1) have demonstrated objective and durab...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Infectious Agents and Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13027-023-00564-1 |
| _version_ | 1827388743597686784 |
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| author | Stella Meireles Siqueira Gabriella Campos-do-Carmo Paulo Ricardo Garcia da Silva Isabele Ávila Small Andreia Cristina De Melo |
| author_facet | Stella Meireles Siqueira Gabriella Campos-do-Carmo Paulo Ricardo Garcia da Silva Isabele Ávila Small Andreia Cristina De Melo |
| author_sort | Stella Meireles Siqueira |
| collection | DOAJ |
| description | Abstract Background Merkel cell carcinoma (MCC) comprises a rare malignant primary skin tumor presenting neuroendocrine differentiation. Recently, agents blocking the programmed cell death protein 1 and programmed cell death protein ligand 1 pathway (PD-1/PD-L1) have demonstrated objective and durable tumor regressions in patients presenting advanced MCC. This study aimed to describe the sociodemographic, clinical, and histopathological characteristics of MCC patients, also assessing the prevalence of PD-L1 expression and Merkel cell Polyomavirus (MCPyV), as well as their prognostic roles. Methods Data from patients diagnosed with MCC between 1996 and 2019 at a reference cancer center in Rio de Janeiro, southeastern Brazil, were evaluated in a retrospective study. Tumor samples were tested for MCPyV and PD-L1 employing immunohistochemistry. Survival analyses were carried out employing the Kaplan–Meier method and curves were compared using the log-rank test. A multiple semiparametric Cox model was used. Values p < 0.05 were considered significant. Results A total of 65 patients were included in the study, with a mean age at diagnosis of 72 (standard deviation 13.9). A total of 56.9% (37/65) of the patients were male, 86.2% (56/65) were white, and 56.9% (37/64) were illiterate or with incomplete elementary school. MCPyV immunohistochemistry was positive in 29 cases (44.6%) and PD-L1 positivity was ≥ 1% in 42 cases (64.6%). Significant associations between MCPyV and PD-L1 expression ≥ 1% (p = 0.003) and PD-L1 expression ≥ 5% (p = 0.005) were noted. Concerning the multivariate analysis, only education level and advanced MCC stage indicated statistically significant worse progression-free survival. Regarding overall survival (OS), being male, education level and advanced stage comprised risk factors. The estimated OS at 60 months for stages I to III was of 48.9% and for stage IV, 8.9%. Conclusions This is the first large Brazilian cohort to assess the prevalence of MCPyV in MCC tumors, as well as PD-L1 expression and their associations. No correlations were noted between MCPyV infection or PD-L1 expression and survival rates. |
| first_indexed | 2024-03-08T16:23:21Z |
| format | Article |
| id | doaj.art-63bd7945162d438e85b4afcc8d2e289f |
| institution | Directory Open Access Journal |
| issn | 1750-9378 |
| language | English |
| last_indexed | 2024-03-08T16:23:21Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj.art-63bd7945162d438e85b4afcc8d2e289f2024-01-07T12:11:55ZengBMCInfectious Agents and Cancer1750-93782024-01-0119111010.1186/s13027-023-00564-1The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma casesStella Meireles Siqueira0Gabriella Campos-do-Carmo1Paulo Ricardo Garcia da Silva2Isabele Ávila Small3Andreia Cristina De Melo4Division of Clinical Research and Technological Development, Brazilian National Cancer InstituteDermatology, Gávea Medical CenterDivision of Pathology, Brazilian National Cancer InstituteDivision of Clinical Research and Technological Development, Brazilian National Cancer InstituteDivision of Clinical Research and Technological Development, Brazilian National Cancer InstituteAbstract Background Merkel cell carcinoma (MCC) comprises a rare malignant primary skin tumor presenting neuroendocrine differentiation. Recently, agents blocking the programmed cell death protein 1 and programmed cell death protein ligand 1 pathway (PD-1/PD-L1) have demonstrated objective and durable tumor regressions in patients presenting advanced MCC. This study aimed to describe the sociodemographic, clinical, and histopathological characteristics of MCC patients, also assessing the prevalence of PD-L1 expression and Merkel cell Polyomavirus (MCPyV), as well as their prognostic roles. Methods Data from patients diagnosed with MCC between 1996 and 2019 at a reference cancer center in Rio de Janeiro, southeastern Brazil, were evaluated in a retrospective study. Tumor samples were tested for MCPyV and PD-L1 employing immunohistochemistry. Survival analyses were carried out employing the Kaplan–Meier method and curves were compared using the log-rank test. A multiple semiparametric Cox model was used. Values p < 0.05 were considered significant. Results A total of 65 patients were included in the study, with a mean age at diagnosis of 72 (standard deviation 13.9). A total of 56.9% (37/65) of the patients were male, 86.2% (56/65) were white, and 56.9% (37/64) were illiterate or with incomplete elementary school. MCPyV immunohistochemistry was positive in 29 cases (44.6%) and PD-L1 positivity was ≥ 1% in 42 cases (64.6%). Significant associations between MCPyV and PD-L1 expression ≥ 1% (p = 0.003) and PD-L1 expression ≥ 5% (p = 0.005) were noted. Concerning the multivariate analysis, only education level and advanced MCC stage indicated statistically significant worse progression-free survival. Regarding overall survival (OS), being male, education level and advanced stage comprised risk factors. The estimated OS at 60 months for stages I to III was of 48.9% and for stage IV, 8.9%. Conclusions This is the first large Brazilian cohort to assess the prevalence of MCPyV in MCC tumors, as well as PD-L1 expression and their associations. No correlations were noted between MCPyV infection or PD-L1 expression and survival rates.https://doi.org/10.1186/s13027-023-00564-1Merkel cell carcinomaMerkel cell polyomavirusProgrammed death ligand-1Skin cancer |
| spellingShingle | Stella Meireles Siqueira Gabriella Campos-do-Carmo Paulo Ricardo Garcia da Silva Isabele Ávila Small Andreia Cristina De Melo The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases Infectious Agents and Cancer Merkel cell carcinoma Merkel cell polyomavirus Programmed death ligand-1 Skin cancer |
| title | The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases |
| title_full | The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases |
| title_fullStr | The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases |
| title_full_unstemmed | The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases |
| title_short | The prognostic role of PD-L1 expression and the presence of polyomavirus in Merkel cell carcinoma cases |
| title_sort | prognostic role of pd l1 expression and the presence of polyomavirus in merkel cell carcinoma cases |
| topic | Merkel cell carcinoma Merkel cell polyomavirus Programmed death ligand-1 Skin cancer |
| url | https://doi.org/10.1186/s13027-023-00564-1 |
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