What is PD-L1?
Cancer cells express PD-L1 (programmed cell death ligand-1) on their surface, which is a receptor for the PD-1 receptor expressed on the surface of activated T cells, and suppress T cell activity through PD-1/PD-L1 binding, thereby evading immune surveillance.1 ),2) In recent years, these immune surveillance mechanisms have been applied to cancer treatment, and anti-PD-1 and anti-PD-L1 antibodies have been developed to enhance T cell activation by inhibiting this binding, and their clinical efficacy and safety have been confirmed in various solid cancers.3 ),4) The
most well-known predictor of the efficacy of these immune checkpoint inhibitors is the expression of PD-L1 on cancer cells, and the PD-L1 IHC test (immunohistochemical staining method), which has been incorporated into clinical trials, is currently being developed to measure the PD-L1 expression rate in cancer tissues and cells, and is being used as a companion diagnostic.
In general, IHC testing is highly invasive and places a large burden on subjects, so research is also underway into liquid biopsies using exosomes that can reduce this burden.
PD-L1 is also expressed on exosomes, and has the same topology as PD-L1 on the surface of cancer cells, with the extracellular domain exposed on the surface of exosomes, which binds to PD-1 on T cells in a concentration-dependent manner5) . In addition, a comparison of circulating exosomes in the blood of metastatic melanoma patients and healthy subjects suggests that PD-L1 levels are significantly higher in metastatic melanoma patients5) . However, this method requires the purification of exosomes by ultracentrifugation, and direct measurement cannot be performed quickly and easily.