Assessment of Programmed Cell Death Protein 1 and Programmed Cell Death Ligand 1 Expression in Gestational Trophoblastic Neoplasia: Implications for Anti-PD1 Drug Therapy

Background & Objective: This study was done to assess the levels of Programmed cell death 1 (PD-1) and its ligands (PD-L1) expression in gestational trophoblastic neoplasia (GTN) to determine the outcome of prescribing anti PD-1 drugs in trophoblastic tumors.Materials & Methods: This study was conducted in the gynecology oncology clinic of Mashhad medical science university in the north-east of Iran during 2012-2022. The patients were divided into two groups consisting of low-risk and high-risk groups based on their International Federation of Gynecology and Obstetrics (FIGO) score, and subsequently their response to the chemotherapy was evaluated. We scored PD-L1 staining in tumor cells using a 4-point scoring system and evaluated PDL-1 expression using the Allered Total Score (ATS).Results: 52 GTN patients with a mean age of 27 were undergone in our study between. Out of all the patients in our study, 47 and 5 patients were diagnosed with molar pregnancy and choriocarcinoma, respectively. The patients with molar pregnancy were also sub grouped into 22 (42.3%) patients and 25 (48.1%) patients with complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). The results of PDL-1 staining intensity showed 3 (5.8%), 12 (23.1%), 27 (51.9%), and 10 (19.2%) were No, weak, moderate, and strong staining, respectively.Conclusion: The findings of this present study indicated that the high-level PD-L1 expression in most of our patients. Seem to suggest the potential use of immune checkpoint inhibition as a treatment option for trophoblastic tumors, which deserves further comprehensive study through clinical trials.