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Study of expression of programmed death ligand 1 and HER2/neu in gastric carcinoma with clinicopathological correlations, in a plan to validate them in immune and targeted therapies

Background Gastric cancer represented the fifth most common malignancy worldwide in both sexes. Targeted therapy against HER2/neu and immune therapy against programmed death ligand 1 (PDL-1) are new therapeutic modalities in many cancers. Objectives This study aimed to investigate the expression profiles of PDL-1 and HER2 protein by immunohistochemistry along with their clinicopathological correlation in gastric carcinoma, intending to validate them as targeted and immune therapies. Patients and methods An immunohistochemistry study for HER2/neu and PDL-1 was done on 76 cases of gastric cancer. Their expressions were correlated with clinicopathological parameters, and it also assessed the correlation between expressions of both markers. Results Positive PDL-1 (combined positive score ≥1% of tumor and/or immune cells) was present in 28% of the study cases. There were significant correlations between combined positive score and sex, depth of infiltration, and TNM staging of the tumor (Mann–Whitney test results; P=0.01, 0.00, and 0.00, respectively). Positive HER2/neu (score 3) was detected in 18% of the study cases. There was a significant association between HER2/neu expression and tumor grade and histopathological variants (Kruskal–Wallis test; P=0.009 and 0.04, respectively). Lowest score of HER2 expression was associated with positive PDL-1 expressions but without significant Spearman’s bivariant correlation test finding. Conclusions There was no obvious relation of PDL-1 and HER2 expression and some of the known predictors of gastric carcinoma. Their use alone in selecting the cases for targeted and immune therapy needs to be further investigation against the survival of the patients and on a larger-scale study with unique scoring criteria.