{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:36:29Z","timestamp":1791995789675,"version":"4.4.0"},"reference-count":46,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Pleural mesothelioma (PM) is a rare type of cancer with poor prognosis. Prognostic and predictive biomarkers could improve treatment strategies in these patients. Programmed death ligand 1 (PD-L1), integrin-linked kinase (ILK) and breast cancer gene 1-associated protein (BAP-1) have been proposed to predict outcomes in PM, but existing data are limited and controversial. Design and Methods: This single-center, retrospective study analyzed data on expression patterns and the prognostic role of PD-L1, ILK and BAP-1 in consecutive patients diagnosed with PM. Results: Of all patients (n = 52) included, more than half showed a positive PD-L1 expression (52% TPS \u2265 1%, 65% CPS \u2265 1), 69% showed a BAP-1 loss and 80% an ILK \u2265 50%. Positive PD-L1 expression was more frequent in the non-epithelioid subtype (p = 0.045). ILK intensity (p = 0.032) and positive PD-L1 (p = 0.034) were associated with more advanced tumor stages. The median overall survival (OS) was 16.9 (95% CI 13.1\u201325.2) months. Multimodality therapy (MMT) including surgery and early stage were independent prognostic factors for longer OS (MMT: HR 0.347, 95% CI 0.13\u20130.90, p = 0.029; advanced stage: HR 4.989; 95% CI 1.64\u201315.13, p = 0.005). Patients with an expression of PD-L1 TPS \u2265 1% or BAP-1 positivity showed numerically worse survival with a median OS of 15.3 (11.5; 24.4) vs. 20.0 (11.2; 34.9) and 11.3 (5.6; 31.0) vs. 20.0 (15.2; 28.1) months, respectively. Furthermore, PD-L1 was associated with worse survival in patients receiving MMT (PD-L1 TPS \u2265 1%: 15.8 (12.1\u201325.4) vs. 31.3 (17.4\u201395.4) p = 0.053). ILK expression \u226550% did not influence survival. The combinations of CPS \u2265 1% with BAP-1 positivity or ILK expression \u226550% were associated with worse survival (p = 0.045, p = 0.019). Conclusions: In this real-world analysis, expressions of PD-L1 and BAP-1 were associated with worse survival in patients with PM. ILK showed no prognostic value. Further studies with larger cohorts are needed to identify prognostic and predictive biomarkers facilitating optimized individual treatment decision in this rare type of cancer.<\/jats:p>","DOI":"10.3390\/jcm13237322","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T11:48:56Z","timestamp":1733226536000},"page":"7322","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Value of PD-L1, BAP-1 and ILK in Pleural Mesothelioma"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-7092","authenticated-orcid":false,"given":"Oliver","family":"Illini","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Clinic Floridsdorf, Vienna Healthcare Group, 1130 Vienna, Austria"},{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6330-1951","authenticated-orcid":false,"given":"Michal","family":"Benej","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Clinic Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Clinical and Translational Thoracic Surgery Research, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3204-8943","authenticated-orcid":false,"given":"Anna Sophie","family":"Lang-St\u00f6berl","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Fabikan","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9098-8416","authenticated-orcid":false,"given":"Luka","family":"Brcic","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Sucher","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Krenbek","sequence":"additional","affiliation":[{"name":"Department of Pathology, Clinic Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor","family":"Krajc","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Clinic Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Clinical and Translational Thoracic Surgery Research, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Weinlinger","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8673-2450","authenticated-orcid":false,"given":"Maximilian J.","family":"Hochmair","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Clinic Floridsdorf, Vienna Healthcare Group, 1130 Vienna, Austria"},{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arschang","family":"Valipour","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Clinic Floridsdorf, Vienna Healthcare Group, 1130 Vienna, Austria"},{"name":"Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Klikovits","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Clinic Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Clinical and Translational Thoracic Surgery Research, Clinic Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4149-4890","authenticated-orcid":false,"given":"Stefan","family":"Watzka","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Clinic Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Clinical and Translational Thoracic Surgery Research, Clinic Floridsdorf, 1210 Vienna, Austria"},{"name":"Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1002\/ijc.26229","article-title":"Pleural malignant mesothelioma epidemic: Incidence, modalities of asbestos exposure and occupations involved from the Italian National Register","volume":"130","author":"Marinaccio","year":"2012","journal-title":"Int. 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