Erratum to "Evaluation of clear cell subtypes of ovarian and uterine malignancies with anti-PD-L1 and anti-PD1 immunohistochemical expression and their association with stage and survival" [Gynecol. Oncol. 155 (2019) 483-488].

Alldredge J, Serna-Gallegos T, Gallegos N, VanLeer JP, Chang J, Ziogas A, Goreal W, Randall L
Gynecologic Oncology · 2020 · doi:10.1016/j.ygyno.2020.02.013 · PMID:32059865 · PMC7397498
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This retrospective study examined PD-L1 and PD-1 expression in ovarian and uterine clear cell carcinomas, finding higher PD-L1 CPS in advanced ovarian cancer and more PD-1 positive lymphocytes in uterine cancers.

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This erratum corrects a retrospective study evaluating PD-1 and PD-L1 expression in pure ovarian and uterine clear cell carcinomas from 1992 to 2017. The analysis of 46 patients revealed that advanced stage ovarian cancers were less likely to express PD-L1, while uterine tumors showed higher rates of PD-1 positive lymphocytes compared to ovarian counterparts. Despite these immunohistochemical findings, there was no significant association between biomarker status and overall survival within the studied cohorts. Relevance to endometriosis: the paper explicitly notes that endometriosis was assessed as a clinical variable in the patient cohort, though the primary focus remains on clear cell malignancies rather than endometriosis itself.

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Methods

This was a retrospective study of paraffin-embedded pure ovarian or uterine CCCs from 1992 to 2017. We assessed stage, endometriosis, and survival time. Immunohistochemical (IHC) staining for PD-1 associated TILs, PD-L1 percentage positivity, and PD-L1 Combined Positive Score (CPS) were performed.

Results

Of the 46 eligible patients, 35 were pure ovarian CCCs and 11 pure uterine CCCs. Most (29/46, 63.0%) were FIGO Stage I or II. We found 34.3% of ovarian tumors and 60% of the uterine tumors were PD-L1 CPS ≥1. PD-1 positive lymphocyteswere present in 39.4% of ovarian tumors and 80% of the uterine tumors. When correlated to stage, ovarian cancer PD-L1 CPS was ≥1 in 28.6% stage I/II, 66.7% stage III, and 0% stage IV cancers (p = 0.03) and PD-1 positive lymphocytes were found in 33.3% stage I/II, 66.7% stage III and 20% stage IV cancers (p=0.227). Within the uterine cohort, there were no significant differences in expression between stages. Multivariate analysis revealed no other significant correlations. There were no differences in overall survival for PD-L1 CPS positive versus negative cohorts among the ovarian cancer population (p= 0.79).

Objective

Clear cell carcinomas (CCCs) of the ovary and uterus are rare and associated with poor prognosis. Information regarding expression of PD-1 positive tumor infiltrating lymphocytes or PD-L1 within gynecologic clear cell malignancies is limited and their role as a biomarker has not been explored.

Conclusions

While limited by sample size, these findings suggest that more advanced ovarian cancer is less likely to express PD-L1 CPS, and that uterine cancers are more likely to have PD-1 positive lymphocytes than ovarian cancers. This biomarker information may better inform exploration of immune checkpoint therapy targeting. The publisher would like to apologise for any inconvenience caused.

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