# Dual biomarker role of PD-L1 and LC3B in glioblastoma: prognostic and therapeutic potential

## TL;DR

This study explores how PD-L1 and LC3B biomarkers are linked to prognosis and treatment outcomes in glioblastoma, suggesting combined immunotherapy and autophagy modulation could improve results.

## Contribution

The study identifies PD-L1 and LC3B as dual biomarkers with prognostic and therapeutic relevance in glioblastoma.

## Key findings

- PD-L1 and LC3B expression are significantly associated with poor prognosis and treatment outcomes in GBM.
- High LC3B expression correlates with increased autophagy and unfavorable survival rates.
- Combining immunotherapy with autophagy modulators may offer a promising treatment strategy for GBM.

## Abstract

GBM, the most common primary malignant brain tumor in adults, has an overall dismal prognosis. Immunotherapy targeting the PD-1/PD-L1 axis has shown limited success in GBM. Resistance to therapies involves different pathways like autophagy. Detecting LC3B expression provides a simple technique for monitoring autophagy. Our goal was to understand the interplay between PD-L1 and LC3B in GBM prognosis and treatment strategies. The study analyzed 61 GBM specimens to assess the immunohistochemical expression of PD-L1 and LC3B with investigating their correlation with various clinicopathological parameters with assessing the impact of PD-L1 and LC3B expression on patients’ survival and the relation between both markers. Both PD-L1 and LC3B were significantly associated with clinicopathological parameters, including Karnofsky performance score (KPS)(P = 0.028 and 0.004 respectively), surgical resection extent (P = 0.023 and 0.002), treatment response(P = 0.015, P ≤ 0.001), patient outcome(p ≤ 0.001), and recurrence (P ≤ 0.001). There was a statistically significant inverse correlation between overall survival (OS) and both PD-L1 and LC3B expression. Additionally, there was a statistically significant inverse correlation between progression-free survival (PFS) and LC3B expression. PD-L1 expression, extent of resection and adjuvant chemotherapy were identified as independent prognostic factors for overall survival in GBM cases. A statistically significant positive relation existed between PD-L1 and LC3B (P ≤ 0.001). Results of this study suggest that the robust expression of PD-L1 in glioblastoma is associated with poor prognosis. Additionally, high expression of LC3B in GBM suggests increased autophagic activity which associated with unfavourable outcome. Combining immunotherapy with autophagy modulators could be a promising approach for improving GBM treatment.