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Abstract：
BACKGROUND: Ovarian clear cell carcinoma (OCCC), well known for its chemoresistance to platinum-based chemotherapy, exhibited a good response in clinical trials of anti-PD-1/PD-L1 inhibitors. By assessing PD-L1 expression, we sought to determine the potential therapeutic benefit of PD-1/PD-L1 inhibitors in OCCC.
RESULTS: The retrospective study included 152 individuals with OCCC between 2019 and 2022 at Peking Union Medical College Hospital. Paired tumors of primary versus recurrent lesions (17 pairs from 15 patients) or primary versus metastatic lesions (11 pairs from 9 patients) were also included. The 22C3 pharmDx assay and whole sections were used for PD-L1 immunohistochemical staining. Pathologists with experience in premarket clinical trials evaluated PD-L1 expression based on various diagnostic criteria (TPS 1%, CPS 1, or CPS 10). The number and percentage of positive PD-L1 cases were 34 (22.4%, TPS ≥ 1%) and 59 (38.8%, CPS ≥ 1), respectively. Thirty-three (21.7%) of the cases had high PD-L1 expression (CPS ≥ 10). Half of the platinum-resistant patients (11/22) were PD-L1 positive (CPS ≥ 1). In addition, positive PD-L1 expression (CPS ≥ 1) was related to clinicopathological characteristics that represented a worse prognosis, such as advanced stages, lymph node metastasis, and distant metastasis (p = 0.032, p < 0.001 and p = 0.003, separately). PD-L1 was expressed equally or more in the recurrent lesion compared with its matched primary lesion.
CONCLUSIONS: In conclusion, anti-PD-1/PD-L1 inhibitors are a promising therapeutic choice for OCCC. For evaluation of PD-L1 expression, CPS is more recommended than TPS. Evaluation of recurrent lesion was still suitable and predictive when the primary tumor tissue was not available. Distant metastatic lesions can serve as alternative samples for PD-L1 evaluation, while usage of lymphatic metastatic lesions is not recommended.
RESULTS: The retrospective study included 152 individuals with OCCC between 2019 and 2022 at Peking Union Medical College Hospital. Paired tumors of primary versus recurrent lesions (17 pairs from 15 patients) or primary versus metastatic lesions (11 pairs from 9 patients) were also included. The 22C3 pharmDx assay and whole sections were used for PD-L1 immunohistochemical staining. Pathologists with experience in premarket clinical trials evaluated PD-L1 expression based on various diagnostic criteria (TPS 1%, CPS 1, or CPS 10). The number and percentage of positive PD-L1 cases were 34 (22.4%, TPS ≥ 1%) and 59 (38.8%, CPS ≥ 1), respectively. Thirty-three (21.7%) of the cases had high PD-L1 expression (CPS ≥ 10). Half of the platinum-resistant patients (11/22) were PD-L1 positive (CPS ≥ 1). In addition, positive PD-L1 expression (CPS ≥ 1) was related to clinicopathological characteristics that represented a worse prognosis, such as advanced stages, lymph node metastasis, and distant metastasis (p = 0.032, p < 0.001 and p = 0.003, separately). PD-L1 was expressed equally or more in the recurrent lesion compared with its matched primary lesion.
CONCLUSIONS: In conclusion, anti-PD-1/PD-L1 inhibitors are a promising therapeutic choice for OCCC. For evaluation of PD-L1 expression, CPS is more recommended than TPS. Evaluation of recurrent lesion was still suitable and predictive when the primary tumor tissue was not available. Distant metastatic lesions can serve as alternative samples for PD-L1 evaluation, while usage of lymphatic metastatic lesions is not recommended.
摘要：
背景：卵巢透明细胞癌（OCCC），以其对铂类化疗的化学抗性而闻名，在抗PD-1/PD-L1抑制剂的临床试验中表现出良好的反应。通过评估PD-L1表达，我们试图确定PD-1/PD-L1抑制剂在OCCC中的潜在治疗益处.
结果：回顾性研究包括北京协和医院2019年至2022年间152名OCCC患者。还包括原发性与复发性病变（来自15例患者的17对）或原发性与转移性病变（来自9例患者的11对）的成对肿瘤。22C3pharmDx测定和整个切片用于PD-L1免疫组织化学染色。具有上市前临床试验经验的病理学家根据各种诊断标准（TPS1％，CPS1或CPS10)。PD-L1阳性例数和百分比为34（22.4%，TPS≥1%)和59(38.8%，CPS≥1),分别。33例（21.7%）患者PD-L1高表达（CPS≥10）。一半的铂类耐药患者（11/22）为PD-L1阳性（CPS≥1）。此外,PD-L1阳性表达（CPS≥1）与预后较差的临床病理特征有关，如高级阶段，淋巴结转移,和远处转移（分别为p=0.032，p<0.001和p=0.003）。与匹配的原发病灶相比，PD-L1在复发病灶中表达相等或更多。
结论：结论：抗PD-1/PD-L1抑制剂是OCCC的有希望的治疗选择.为了评估PD-L1的表达，CPS比TPS更推荐。当无法获得原发肿瘤组织时，对复发病变的评估仍然是合适和可预测的。远处转移性病变可以作为PD-L1评估的替代样本，而不建议使用淋巴转移性病变。
结果：回顾性研究包括北京协和医院2019年至2022年间152名OCCC患者。还包括原发性与复发性病变（来自15例患者的17对）或原发性与转移性病变（来自9例患者的11对）的成对肿瘤。22C3pharmDx测定和整个切片用于PD-L1免疫组织化学染色。具有上市前临床试验经验的病理学家根据各种诊断标准（TPS1％，CPS1或CPS10)。PD-L1阳性例数和百分比为34（22.4%，TPS≥1%)和59(38.8%，CPS≥1),分别。33例（21.7%）患者PD-L1高表达（CPS≥10）。一半的铂类耐药患者（11/22）为PD-L1阳性（CPS≥1）。此外,PD-L1阳性表达（CPS≥1）与预后较差的临床病理特征有关，如高级阶段，淋巴结转移,和远处转移（分别为p=0.032，p<0.001和p=0.003）。与匹配的原发病灶相比，PD-L1在复发病灶中表达相等或更多。
结论：结论：抗PD-1/PD-L1抑制剂是OCCC的有希望的治疗选择.为了评估PD-L1的表达，CPS比TPS更推荐。当无法获得原发肿瘤组织时，对复发病变的评估仍然是合适和可预测的。远处转移性病变可以作为PD-L1评估的替代样本，而不建议使用淋巴转移性病变。
