{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:26:09Z","timestamp":1780320369068,"version":"3.54.1"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have limited therapeutic options. The role of programmed death-ligand 1 (PD-L1) in their clinicopathology, immune markers, and prognosis remains controversial. This meta-analysis aimed to systematically clarify these relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched Medline\/PubMed, Web of Science, Embase, and Cochrane Library from inception to November 2025 for studies on PD-L1 expression in GEP-NENs. Two researchers independently extracted data and assessed quality via Newcastle-Ottawa Scale (NOS). Pooled analyses were conducted using Stata 17.0, with odds ratio (OR)\/hazard ratio (HR) and 95% confidence interval (CI) as effect indicators, and fixed\/random-effects models chosen by heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 22 studies involving 1,872 patients (17 high-quality and 5 moderate-quality) were included. High PD-L1 expression was significantly associated with higher tumor grade (OR = 3.78, 95% CI:2.04-7.01; p&amp;lt;0.001), poorer differentiation (OR = 2.80, 95% CI:1.18-6.65; p=0.020), increased PD-1 expression (OR = 4.15, 95% CI:2.16-7.99; p&amp;lt;0.001), and shorter overall survival (HR = 1.66, 95% CI:1.32-2.10; p&amp;lt;0.001). No significant associations were found with sex, age, histological type, tumor stage, invasion, metastasis, CD8+ T cell\/FOXP3+ T cell infiltration, or mismatch repair (MMR) status. No publication bias existed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High PD-L1 expression in GEP-NENs correlates with aggressive clinicopathological features, PD-1 upregulation, and unfavorable prognosis. PD-L1 may serve as a prognostic biomarker and therapeutic target for immune checkpoint inhibitors, particularly in high-grade\/poorly differentiated tumors. Large-scale prospective studies are needed for validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO<\/jats:ext-link>\n                      , identifier CRD420251048602.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1772011","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T07:20:14Z","timestamp":1770880814000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation between PD-L1 expression and clinical pathology, immunobiological markers, and prognosis in gastroenteropancreatic neuroendocrine neoplasms: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Qiming","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of General Surgery\/Transplantation, First Central Hospital of Tianjin Medical University","place":["Tianjin, China"]},{"name":"Department of Liver Transplantation, Tianjin First Central Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory for Organ Transplantation, Tianjin First Center Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangbo","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic Spleen Surgery, Baoji People\u2019s Hospital","place":["Baoji, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of General Surgery\/Transplantation, First Central Hospital of Tianjin Medical University","place":["Tianjin, China"]},{"name":"Department of Liver Transplantation, Tianjin First Central Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory for Organ Transplantation, Tianjin First Center Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingjun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of General Surgery\/Transplantation, First Central Hospital of Tianjin Medical University","place":["Tianjin, China"]},{"name":"Department of Liver Transplantation, Tianjin First Central Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory for Organ Transplantation, Tianjin First Center Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery\/Transplantation, First Central Hospital of Tianjin Medical University","place":["Tianjin, China"]},{"name":"Department of Liver Transplantation, Tianjin First Central Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory for Organ Transplantation, Tianjin First Center Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of General Surgery\/Transplantation, First Central Hospital of Tianjin Medical University","place":["Tianjin, China"]},{"name":"Department of Liver Transplantation, Tianjin First Central Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Molecular Diagnosis and Treatment of Liver Cancer, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory for Organ Transplantation, Tianjin First Center Hospital","place":["Tianjin, China"]},{"name":"Institute of Transplantation Medicine, Nankai University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29099","article-title":"Exploring the rising incidence of neuroendocrine tumors: a population-based analysis of epidemiology, metastatic presentation, and outcomes","volume":"121","author":"Hallet","year":"2015","journal-title":"Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \u201ccarcinoid\u201d: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States","volume":"26","author":"Yao","year":"2008","journal-title":"J Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.03.304","article-title":"Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Pavel","year":"2020","journal-title":"Ann Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-017-1273-x","article-title":"Increased incidence trend of low-grade and high-grade neuroendocrine neoplasms","volume":"58","author":"Leoncini","year":"2017","journal-title":"Endocrine"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-007-0452-1","article-title":"TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system","volume":"451","author":"Rindi","year":"2007","journal-title":"Virchows Arch"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21840","article-title":"Critical updates in neuroendocrine tumors: Version 9 American Joint Committee on Cancer staging system for gastroenteropancreatic neuroendocrine tumors","volume":"74","author":"Chauhan","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2021.102299","article-title":"Prognostic factors for relapse in resected gastroenteropancreatic neuroendocrine neoplasms: A systematic review and meta-analysis","volume":"101","author":"Broadbent","year":"2021","journal-title":"Cancer Treat Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1409757","article-title":"Lanreotide in metastatic enteropancreatic neuroendocrine tumors","volume":"371","author":"Caplin","year":"2014","journal-title":"N Engl J Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199202203260804","article-title":"Streptozocin-doxorubicin, streptozocin-fluorouracil or chlorozotocin in the treatment of advanced islet-cell carcinoma","volume":"326","author":"Moertel","year":"1992","journal-title":"N Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-017-3925-8","article-title":"Investigation of receptor radionuclide therapy with 177Lu-DOTATATE in patients with GEP-NEN and a high Ki-67 proliferation index","volume":"45","author":"Nicolini","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00817-X","article-title":"Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study","volume":"387","author":"Yao","year":"2016","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000061","article-title":"Inducible expression of B7-H1 (PD-L1) and its selective role in tumor site immune modulation","volume":"20","author":"Sanmamed","year":"2014","journal-title":"Cancer J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s13045-017-0541-9","article-title":"Recent development in clinical applications of PD-1 and PD-L1 antibodies for cancer immunotherapy","volume":"10","author":"Liu","year":"2017","journal-title":"J Hematol Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01597","article-title":"PD-1\/PD-L1 blockade: have we found the key to unleash the antitumor immune response","volume":"8","author":"Xu-Monette","year":"2017","journal-title":"Front Immunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01448","article-title":"Outcomes with postrecurrence systemic therapy following adjuvant checkpoint inhibitor treatment for resected melanoma in checkMate 238","volume":"42","author":"Weber","year":"2024","journal-title":"J Clin Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.scib.2023.12.046","article-title":"PD-L1 expression guidance on sintilimab versus pembrolizumab with or without platinum-doublet chemotherapy in untreated patients with advanced non-small cell lung cancer (CTONG1901): A phase 2, randomized, controlled trial","volume":"69","author":"Maggie Liu","year":"2024","journal-title":"Sci Bull (Beijing)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02126-1","article-title":"Atezolizumab plus anthracycline-based chemotherapy in metastatic triple-negative breast cancer: the randomized, double-blind phase 2b ALICE trial","volume":"28","author":"R\u00f8ssevold","year":"2022","journal-title":"Nat Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"B20","unstructured":"Newcastle-Ottawa quality assessment scale cohort studies\n          \n          \n            \n              Wells\n              G\n            \n            \n              Shea\n              B\n            \n            \n              O\u2019Connell\n              D\n            \n            \n              Peterson\n              J\n            \n            \n              Welch\n              V\n            \n            \n              Losos\n              M\n            \n          \n          Univ Ott\n          \n          2014"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/22.4.719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"Mantel","year":"1959","journal-title":"J Natl Cancer Inst"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.2307\/2533446","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"50","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-8-16","article-title":"Practical methods for incorporating summary time-to-event data into meta-analysis","volume":"8","author":"Tierney","year":"2007","journal-title":"Trials"},{"key":"B26","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1530\/ERC-18-0494","article-title":"Immune checkpoint markers in gastroenteropancreatic neuroendocrine neoplasia","volume":"26","author":"B\u00f6sch","year":"2019","journal-title":"Endocr Relat Cancer"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1159\/000503722","article-title":"Gastroenteropancreatic high-grade neuroendocrine neoplasms: histology and molecular analysis, two sides of the same coin","volume":"110","author":"Busico","year":"2020","journal-title":"Neuroendocrinology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e3004","DOI":"10.1038\/cddis.2017.401","article-title":"Role of PD-L1 expression as a biomarker for GEP neuroendocrine neoplasm grading","volume":"8","author":"Cavalcanti","year":"2017","journal-title":"Cell Death Dis"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10081741","article-title":"Myeloid and T-cell microenvironment immune features identify two prognostic sub-groups in high-grade gastroenteropancreatic neuroendocrine neoplasms","volume":"10","author":"Centonze","year":"2021","journal-title":"J Clin Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"24669","DOI":"10.1038\/s41598-024-75882-4","article-title":"The prognostic and therapeutic value of the tumor microenvironment and immune checkpoints in pancreatic neuroendocrine neoplasms","volume":"14","author":"Chen","year":"2024","journal-title":"Sci Rep"},{"key":"B31","article-title":"Differences in clinicopathology and prognosis between gastroesophageal junctional and gastric non-cardiac neuroendocrine carcinomas: a retrospective comparison study of consecutive 56 cases from a single institution in China","volume":"12","author":"Cheng","year":"2022","journal-title":"Am J Cancer Res"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-18-0189","article-title":"Analysis of the immune landscape of small bowel neuroendocrine tumors","volume":"26","author":"Cives","year":"2019","journal-title":"Endocr Relat Cancer"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/07357907.2024.2330102","article-title":"Retrospective analyses of PD-L1, LAG-3, TIM-3, OX40L expressions and MSI status in gastroenteropancreatic neuroendocrine neoplasms","volume":"42","author":"G\u00fcrler","year":"2024","journal-title":"Cancer Invest"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.5648-20","article-title":"Pathological findings of the host immune reaction in the tumor microenvironment of gastroenteropancreatic neuroendocrine neoplasms","volume":"60","author":"Hasegawa","year":"2021","journal-title":"Intern Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.7150\/jca.13711","article-title":"The impact of PD-L1 expression in patients with metastatic GEP-NETs","volume":"7","author":"Kim","year":"2016","journal-title":"J Cancer"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e00842","DOI":"10.14309\/ctg.0000000000000842","article-title":"Expression patterns of immune checkpoint molecules and their clinical values in gastric neuroendocrine neoplasms","volume":"16","author":"Liang","year":"2025","journal-title":"Clin Transl Gastroenterol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.135","article-title":"Microenvironment and tumor inflammatory features improve prognostic prediction in gastro-entero-pancreatic neuroendocrine neoplasms","volume":"5","author":"Milione","year":"2019","journal-title":"J Pathol Clin Res"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-024-03825-5","article-title":"PD-L1 expression, tumor-infiltrating lymphocytes, and mismatch repair proteins status in digestive neuroendocrine neoplasms: exploring their potential role as theragnostic and prognostic biomarkers","volume":"485","author":"Multone","year":"2024","journal-title":"Virchows Arch"},{"key":"B39","article-title":"Programmed cell death ligand-1 expression in gastroenteropancreatic neuroendocrine tumors","volume":"24","author":"Oktay","year":"2019","journal-title":"J BUON"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.7569","article-title":"Immunohistochemical CD73 expression status in gastrointestinal neuroendocrine neoplasms: A retrospective study of 136 patients","volume":"15","author":"Ono","year":"2018","journal-title":"Oncol Lett"},{"key":"B41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.humpath.2017.10.003","article-title":"Expression of PD-1 and PD-L1 in poorly differentiated neuroendocrine carcinomas of the digestive system: a potential target for anti-PD-1\/PD-L1 therapy","volume":"70","author":"Roberts","year":"2017","journal-title":"Hum Pathol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-21-0223","article-title":"Antitumor immune response is associated with favorable survival in GEP-NEN G3","volume":"28","author":"Rosery","year":"2021","journal-title":"Endocr Relat Cancer"},{"key":"B43","article-title":"The clinical significance of PD-L1\/PD-1 expression in gastroenteropancreatic neuroendocrine neoplasia","volume":"49","author":"Wang","year":"2019","journal-title":"Ann Clin Lab Sci"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.00132","article-title":"Immune checkpoint markers in neuroendocrine carcinoma of the digestive system","volume":"10","author":"Xing","year":"2020","journal-title":"Front Oncol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1111\/his.14230","article-title":"Programmed cell death protein 1\/programmed death ligand 1 but not HER2 is a potential therapeutic target in gastric neuroendocrine carcinoma","volume":"78","author":"Yamashita","year":"2021","journal-title":"Histopathology"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i14.1684","article-title":"Clinical significance of programmed death 1\/programmed death ligand 1 pathway in gastric neuroendocrine carcinomas","volume":"25","author":"Yang","year":"2019","journal-title":"World J Gastroenterol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-20-0382","article-title":"Spartalizumab in metastatic, well\/poorly-differentiated neuroendocrine neoplasms","volume":"28","author":"Yao","year":"2021","journal-title":"Endocr Relat Cancer"},{"key":"B48","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12943-024-02095-8","article-title":"Programmed death receptor (PD-)1\/PD-ligand (L)1 in urological cancers: the \u201call-around warrior\u201d in immunotherapy","volume":"23","author":"Liu","year":"2024","journal-title":"Mol Cancer"},{"key":"B49","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.ccell.2023.02.005","article-title":"Tumor PD-L1 engages myeloid PD-1 to suppress type I interferon to impair cytotoxic T lymphocyte recruitment","volume":"41","author":"Klement","year":"2023","journal-title":"Cancer Cell"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000064","article-title":"Patterns and prognostic values of programmed cell death-ligand 1 expression and CD8+ T-cell infiltration in small cell carcinoma of the esophagus: a retrospective analysis of 34 years of National Cancer Center data in China","volume":"110","author":"Zhang","year":"2024","journal-title":"Int J Surg"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1038\/s41573-022-00493-5","article-title":"Adaptive immune resistance at the tumour site: mechanisms and therapeutic opportunities","volume":"21","author":"Kim","year":"2022","journal-title":"Nat Rev Drug Discov"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-020-09657-8","article-title":"Diagnostic and predictive role of DLL3 expression in gastroenteropancreatic neuroendocrine neoplasms","volume":"32","author":"Liverani","year":"2021","journal-title":"Endocr Pathol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.labinv.2023.100210","article-title":"PD-L1 expression is linked to tumor-infiltrating T-cell exhaustion and adverse pathological behavior in pheochromocytoma\/paraganglioma","volume":"103","author":"Yu","year":"2023","journal-title":"Lab Invest"},{"key":"B54","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1186\/s12943-024-02201-w","article-title":"The miR-23a\/27a\/24\u20132 cluster drives immune evasion and resistance to PD-1\/PD-L1 blockade in non-small cell lung cancer","volume":"23","author":"Luo","year":"2024","journal-title":"Mol Cancer"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-21-1463","article-title":"Enhancing PD-L1 degradation by ITCH during MAPK inhibitor therapy suppresses acquired resistance","volume":"12","author":"Yang","year":"2022","journal-title":"Cancer Discov"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.3390\/cells10113166","article-title":"What do we have to know about PD-L1 expression in prostate cancer? A systematic literature review. Part 1: focus on immunohistochemical results with discussion of pre-analytical and interpretation variables","volume":"10","author":"Palicelli","year":"2021","journal-title":"Cells"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003624","article-title":"Immunohistochemically detected expression of ATRX, TSC2, and PTEN predicts clinical outcomes in patients with grade 1 and 2 pancreatic neuroendocrine tumors","volume":"274","author":"Uemura","year":"2021","journal-title":"Ann Surg"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.680973","article-title":"Impact of PD-L1 and PD-1 expression on the prognostic significance of CD8+ Tumor-infiltrating lymphocytes in non-small cell lung cancer","volume":"12","author":"Munari","year":"2021","journal-title":"Front Immunol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.02077","article-title":"Clinicopathologic significance and prognostic value of programmed cell death ligand 1 (PD-L1) in patients with hepatocellular carcinoma: A meta-analysis","volume":"9","author":"Li","year":"2018","journal-title":"Front Immunol"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.21037\/jgo-20-568","article-title":"Clinicopathological and prognostic significance of programmed death ligant-1 expression in gastric cancer: a meta-analysis","volume":"12","author":"Qiu","year":"2021","journal-title":"J Gastrointest Oncol"},{"key":"B61","doi-asserted-by":"publisher","first-page":"e241215","DOI":"10.1001\/jamanetworkopen.2024.1215","article-title":"Significance of PD-L1 in metastatic urothelial carcinoma treated with immune checkpoint inhibitors: A systematic review and meta-analysis","volume":"7","author":"Maiorano","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B62","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.ejca.2022.03.029","article-title":"Avelumab in unresectable\/metastatic, progressive, grade 2\u20133 neuroendocrine neoplasms (NENs): Combined results from NET-001 and NET-002 trials","volume":"169","author":"Chan","year":"2022","journal-title":"Eur J Cancer"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1569864","article-title":"Efficacy of neoadjuvant, adjuvant, and perioperative immunotherapy in non-small cell lung cancer across different PD-L1 expression levels: a systematic review and meta-analysis","volume":"16","author":"Zhang","year":"2025","journal-title":"Front Immunol"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103249","article-title":"Efficacy and safety of HBM4003 combined with toripalimab in refractory neuroendocrine neoplasms: a multicenter, phase II study","volume":"84","author":"Zhang","year":"2025","journal-title":"EClinicalMedicine"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100364","article-title":"Efficacy of ipilimumab and nivolumab in patients with high-grade neuroendocrine neoplasms","volume":"7","author":"Al-Toubah","year":"2022","journal-title":"ESMO Open"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1038\/s43018-025-00916-3","article-title":"Regorafenib plus avelumab in advanced gastroenteropancreatic neuroendocrine neoplasms: a phase 2 trial and correlative analysis","volume":"6","author":"Cousin","year":"2025","journal-title":"Nat Cancer"},{"key":"B67","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.semcancer.2025.02.005","article-title":"Inflammation and tumor immune escape in response to DNA damage","volume":"110","author":"Nihira","year":"2025","journal-title":"Semin Cancer Biol"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.01.013","article-title":"Programmed death-ligand 1 copy number loss in NSCLC associates with reduced programmed death-ligand 1 tumor staining and a cold immunophenotype","volume":"17","author":"Aujla","year":"2022","journal-title":"J Thorac Oncol"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-021-09647-z","article-title":"Present and future of immunotherapy in Neuroendocrine Tumors","volume":"22","author":"Albertelli","year":"2021","journal-title":"Rev Endocr Metab Disord"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1772011\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:27:27Z","timestamp":1771928847000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1772011\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":69,"alternative-id":["10.3389\/fimmu.2026.1772011"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1772011","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]},"article-number":"1772011"}}