Expression of Nectin-4 and Pd-L1 in Upper Tract Urothelial Carcinoma Publisher Pubmed



Tomiyama E¹ ; Fujita K^{1, 2} ; Rodriguez Pena MDC^{3, 4} ; Taheri D^{3, 5} ; Banno E² ; Kato T^{1, 6} ; Hatano K¹ ; Kawashima A¹ ; Ujike T¹ ; Uemura M^{1, 6} ; Takao T⁷ ; Yamaguchi S⁷ ; Fushimi H⁸ ; Yoshimura K² Show All Authors Show Affiliations
Source: International Journal of Molecular Sciences Published:2020

Abstract

Enfortumab vedotin is a novel antibody–drug conjugate targeting Nectin-4, which is highly expressed in urothelial carcinoma. However, the expression status of Nectin-4 in upper tract urothelial carcinoma (UTUC) remains unclear. The relationship between Nectin-4 and Programmed Death Ligand 1 (PD-L1) in UTUC is also ambiguous. We performed immunohistochemical analysis of 99 UTUC tissue microarray to assess the expression of Nectin-4 and PD-L1 in UTUC. Nectin-4-positivity was detected in 65 (65.7%) samples, and PD-L1 was detected in 24 (24.2%) samples. There was no correlation between the expression of Nectin-4 and PD-L1. Patients with strong Nectin-4-expressing tumors had a significantly higher risk of progression (p = 0.031) and cancer-specific mortality (p = 0.036). Strong Nectin-4 expression was also an independent predictor of disease progression in the high-risk group (pT3 ≤ or presence of lymphovascular invasion or lymph node metastasis) (Hazard ratio, 3.32 [95% confidence interval, 1.20–7.98; p = 0.027]). In conclusion, we demonstrated that Nectin-4 expression rate in UTUC was 65.7% and independent of PD-L1 expression. Strong Nectin-4 expression was associated with worse progression-free survival in high-risk UTUC. These findings suggested that enfortumab vedotin may be effective in a broad range of patients with UTUC, regardless of PD-L1 expression. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.