Abstract
The immune system is important to control tumor development and progression in humans.
However, tumor cells and cells of the tumor microenvironment can induce immune escape mechanisms
including activation of immune checkpoints such as PD-1/PD-L1. Based on this knowledge,
new immune therapies, including PD-1 and PD-L1 inhibition, have been developed and are already
recommended as a standard treatment in metastatic bladder and kidney cancer patients. In addition to
its role as a therapeutic target, PD-L1 seems to be a prognostic parameter although data are controversial.
Only little is known about signaling pathways inducing PD-L1 expression in tumor cells on one
hand and about its functional role for tumor cells itself. However, the understanding of the complex
biological function of PD-L1 will improve therapeutic options in urological malignancies. This review
is giving an overview of the current knowledge concerning the PD-1/PD-L1 axis in urological tumors
including bladder, kidney, prostate, testicular and penile cancer.
Keywords:
Checkpoint inhibition, PD-L1, bladder cancer, prostate cancer, kidney cancer, testicular germ cell tumors, penile
cancer.
Graphical Abstract
[21]
Keytruda (pembrolizumab) or Tecentriq (atezolizumab): FDA
Alerts Health Care Professionals and Investigators: FDA Statement
- Decreased Survival in Some Patients in Clinical Trials Associated
with Monotherapy. 2018.
[22]
EMA restricts use of Keytruda and Tecentriq in bladder cancer
Data show lower survival in some patients with low levels of
cancer protein PD-L1 2018.
[33]
Boorjian SA, Sheinin Y, Crispen PL, Farmer SA, Lohse CM, Kuntz SM, et al. T-cell coregulatory molecule expression in urothelial cell carcinoma: clinicopathologic correlations and association with survival. Clin Cancer Res 2008; 14(15): 4800-8.
[34]
Faraj SF, Munari E, Guner G, Taube J, Anders R, Hicks J, et al. Assessment of tumoral PD-L1 expression and intratumoral CD8+ T cells in urothelial carcinoma. Urology 2015; 85(3): 703 e1-6.
[59]
Carlsson J, Sundqvist P, Kosuta V, Falt A, Giunchi F, Fiorentino M, et al. Pd-l1 expression is associated with poor prognosis in renal cell carcinoma. applied immunohistochemistry & molecular morphology : AIMM 2019.
[64]
Ueda K, Suekane S, Kurose H, Chikui K, Nakiri M, Nishihara K, et al. Prognostic value of PD-1 and PD-L1 expression in patients with metastatic clear cell renal cell carcinoma. Urologic Oncology: Seminars and Original Investigations 2018; 36(11): 499.e9-e16.
[89]
Deng C, Li Z, Guo S, Chen P, Chen X, Zhou Q, et al. Tumor PD-L1 expression is correlated with increased TILs and poor prognosis in penile squamous cell carcinoma. Oncoimmunology 2016; 6(2) e1269047.
[99]
Cimadamore A, Lopez-Beltran A, Massari F, Santoni M, Mazzucchelli R, Scarpelli M, et al. Germline and somatic mutations in prostate cancer: focus on defective DNA repair, PARP inhibitors and immunotherapy. Future Oncol 0(0): null.