Programmed cell death-ligand 1 expression in oral squamous cell carcinoma is associated with an inflammatory phenotype

Phase 2 clinical trials utilising novel anti-PD1/PD-L1 antibodies are being conducted in oral cavity squamous cell carcinoma (OSCC) patients. However, data regarding PD-L1 expression in OSCC is limited. The aim of this study was to characterise the PD-L1 immunohistochemical expression in OSCC and its association with clinicopathological factors. Clinicopathological review of 217 patients with OSCC was performed, including quantifying tumour-infiltrating lymphocytes. Immunohistochemistry with PD-L1, CD4 and CD8 was performed. Forty (18.3%) cases showed PD-L1 expression. Expression was significantly more frequent in females (p = 0.013), tongue/buccal mucosal SCCs (p = 0.05), and in tumours with a high lymphocytic infiltrate (p > 0.001). Intratumoural heterogeneity of PD-L1 expression was observed in 30% of the cases. PD-L1 expression was not significantly associated with disease-free (p = 0.82) or overall survival (p = 0.93). PD-L1 expression occurred in a significant minority of OSCC and can be heterogeneous. Frequent PD-L1 expression in OSCCs in females and in tumours with high lymphocytic infiltrate may assist in the selection of patients who may respond to anti-PD1/PD-L1 therapies.