PD-L1 expression in clear cell renal cell carcinoma: An analysis of nephrectomy and sites of metastases

L. B. Jilaveanu, Brain Shuch, C. R. Zito, F. Parisi, M. Barr, Y. Kluger, L. Chen, H. M. Kluger

Research output: Contribution to journalArticlepeer-review

107 Scopus citations


Background: Expression of programmed death ligand (PD-L1/B7-H1/CD274) represents a mechanism of immune escape for renal cell carcinoma (RCC) cells. Drugs blocking PD-L1 or its receptor are in clinical development and early data suggests that tumor PD-L1 expression may predict response. Patients and Methods: A tissue microarray (TMA) consisting of four biopsy cores from 34 matched pairs of nephrectomy and metastatic sites of clear cell RCC was used to assess PD-L1expression by quantitative immunofluorescence. Assessment of intra- and inter-tumor heterogeneity and primary and metastatic tumor expression was performed using a method of Automated Quantitative Analysis (AQUA). Results: The median AQUA scores were higher in metastatic than primary specimens (P <0.0001). The correlation between PD-L1 expression in matched primary and metastatic specimens was weak (R= 0.24). Within a given tumor, variable PD-L1 staining heterogeneity was seen, however the degree of heterogeneity was similar in primary and metastatic sites (P = 0.482). Conclusions: The weak correlation between PD-L1 expression in primary and metastatic sites for a given patient suggests that expression in nephrectomy specimens cannot be used to select metastatic RCC patients for PD-L1 and PD-1 inhibitors. The intra-tumor heterogeneity seen in both primary and metastatic specimens indicates that a single core biopsy might not be sufficient to determine PD-L1 expression.

Original languageEnglish (US)
Pages (from-to)166-172
Number of pages7
JournalJournal of Cancer
Issue number3
StatePublished - 2014
Externally publishedYes


  • PD-L1
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Oncology


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