In February, Y. J. Kim, from the Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, and colleagues published in the Journal of the European Academy of Dermatology and Venereology the results of a study investigating the potential use of Programmed Death-1 (PD-1) expression as a prognostic marker in cutaneous Extranodal Natural Killer/T-Cell Lymphoma (ENKTL).
- Retrospective analysis of 41 ENKTL pts with biopsy confirmed cases at the Asan Medical Center between Jan 1998–Dec 2015, median age 45.2 years
- Immunohistochemical staining performed to assess PD-1 expression, where >10% cells being stained was classed as a positive case
- Primary cutaneous ENKTL = 24 pts
- Secondary cutaneous ENKTL = 17 pts
- Pts with PD-1-positive lesions = 53.7% (n=22)
- No significant difference in PD-1 positivity between:
- Disease stage (P = 0.205)
- IPI scores (P = 0.397)
- Primary and secondary cutaneous ENKTL (P = 0.233)
- Overall median OS = 37 months (95% CI, 28.46–45.53 months)
- PD-1-positive: median OS = 47 months
- PD-1-negative: median OS = 36 months
- Overall median PFS = 11 months (95% CI, 6.72–15.28 months)
- PD-1-positive: median PFS = 12 months
- PD-1-negative: median PFS = 8 months
- No difference seen between PD-1 positive and negative ENKTL patients in median OS (P = 0.582) or PFS (P = 0.513)
In conclusion, the authors stated that PD-1 expression was shown to not have any prognostic value in cutaneous ENKTL, although this study was both retrospective and had a small sample size. Further prospective studies would need to be conducted to confirm these findings.
- Kim Y. J. et al. Expression of programmed death-1 in cutaneous extranodal natural killer/T-cell lymphoma and its effect on clinical findings and biological behavior. Journal of the European Academy of Dermatology and Venereology. 2017 Feb 11. DOI: 1111/jdv.14165 [Epub ahead of print: 2017 Feb 11].
Background. Recent studies have evaluated the expression of programmed death-1 (PD-1) and its prognostic value in malignant T-cell lymphomas. Objectives. This study investigated whether the positivity of PD-1 was associated with the clinical characteristics of cutaneous extranodal NK/T-cell lymphoma (ENKTL) and evaluated its effects on survival outcomes. Methods. Forty-one patients with cutaneous ENKTL were included. Clinical features and survival outcomes were analyzed according to the positivity of PD-1. Results. There was no significant difference between primary cutaneous ENKTL and secondary cutaneous ENKTL in the expression of PD-1. The degree of disease dissemination was not affected by the positivity of PD-1. Higher positivity for PD-1 was associated with lesions presenting erythematous to purpuric patches that are mainly composed of small tumor cells. Cutaneous ENKTL presenting nodular lesions had a significantly lower number of PD-1-positive infiltrating cells than those with other clinical morphologies. There was no significant effect of PD-1 expression on outcomes such as overall and progression-free survival. Limitations. The present study used a retrospective design and had a small sample size. Conclusion. Higher PD-1 positivity is associated with small-cell-predominant cutaneous ENKTL. However, PD-1 expression has no prognostic value in cutaneous ENKTL.