Response and survival impact of PD-L1 status in metastatic urothelial carcinoma treated with immune checkpoint inhibitors: meta-analysis

There is no consensus on the association of PD-L1 status with response and survival of patients with metastatic urothelial carcinoma (mUC) treated with immune checkpoint inhibitors (ICIs). A systematic review and meta-analysis of 14 phase 1 to 3 studies found an association between PD-L1 status and overall response rate, favoring patients with PD-L1 positive tumors. There was a significant reduction in risk of disease progression and death for patients with PD-L1 positive tumors compared with patients with PD-L1 negative tumors. The authors conclude that PD-L1 positive tumors are associated with improved prognosis among mUC patients receiving ICIs. But since approximately 1 in 5 PD-L1 negative patients also responded to ICIs, it seems unlikely that PD-L1 can be useful as a predictive biomarker for ICI treatment in mUC.