Analysis of PD-L1 Expression in Breast Cancer: A Systematic Review and Meta-Analysis in Asian Population

Document Type : Systematic Review and Meta-analysis


1 Department of Surgery, Division of Surgical Oncology, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia.

2 Department of Biochemistry, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia.

3 Medical Student, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia.

4 Internship Doctor, Wangaya Regional Public Hospital, Denpasar, Bali, Indonesia.


Objective: This study aimed to investigate the level of PD-L1 protein expression in patients with BCs who were of Asian descent. Methods: Three databases were conducted on this article up to August 10th, 2022. The reference lists of the publications were examined for further studies, and in cases of duplicates, a study with a larger sample size was added. In survival analysis, the hazard ratio (HR) was applied to the circumstances characterized by the frequency of occurrences, and for the clinicopathological characteristic, the best-adjusted odds ratio (OR) with a 95% confidence interval (CI) was employed. The Newcastle-Ottawa Scale (NOS) was utilized to evaluate selection criteria, comparison, and exposure to establish the quality of the technique in the under-consideration studies. The Z test determined the association analysis of OS, DFS, and clinicopathological characteristics with PD-L1 expression. Result: All eight trials for OS and six for DFS were considered, with 4.111 and 3.071 participants, respectively. Overexpression of PD-L1 was linked to a reduced OS compared to individuals with undetectable expression (HR= 1.58, 95% CI 1.04–2.40; P=0.03). We analyzed clinicopathological features, and it elevated in individuals with histological grade III (OR=2.39, 95% CI 1.26-4.54; P=0.008) and positive node (OR=0.68, 95% CI 0.48-0.97; P<0.05). Conclusion: Overexpression of PD-L1 was associated with a shorter OS in BCs patients. High PDL1 was higher in persons with nodal positivity and histological grade III.


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