B7-H1 expression in malignant pleural mesothelioma is associated with sarcomatoid histology and poor prognosis

Aaron Scott Mansfield, Anja C. Roden, Tobias Peikert, Yuri M. Sheinin, Susan M. Harrington, Christopher J. Krco, Haidong Dong, Eugene D. Kwon

Research output: Contribution to journalArticlepeer-review

148 Scopus citations


Introduction: B7 homolog 1 (B7-H1; aka programmed cell death 1 ligand 1) is a negative costimulatory molecule that is associated with poor prognosis in many tumor types. Given the poor prognosis and the limited treatments available for mesothelioma, we decided to examine B7-H1 expression and its association with survival in patients with mesothelioma. Methods: Expression of B7-H1 was determined in 106 patients using a mouse monoclonal antihuman B7-H1 (clone 5H1-A3) antibody with immunohistochemistry. Positive expression was defined as 5% positively stained cells. Clinicopathologic features and survival were compared between B7-H1-positive and B7-H1-negative groups. Results: Malignant mesotheliomas of 42 patients (40%) expressed B7-H1. Patients with B7-H1-postive tumors were less likely to be offered or undergo therapeutic surgery (p = 0.03). All sarcomatoid mesotheliomas except one desmoplastic subtype expressed B7-H1. Survival was significantly decreased for patients whose tumors expressed B7-H1 (5 months median, 2-9.5 months interquartile range) compared with those whose tumors did not (14.5 months, 9.25-19 months; p < 0.0001). In a multivariate model, B7-H1 expression and sarcomatoid mesothelioma remained significantly associated with worse survival (risk ratio 1.71, 95% confidence interval 1.03-2.78 [p = 0.04] and risk ratio 2.18, 1.08-4.23 [p = 0.03], respectively). Conclusions: B7-H1 is expressed in a substantial proportion of malignant pleural mesotheliomas and is associated with poor survival. Almost all malignant pleural mesotheliomas with sarcomatoid differentiation expressed B7-H1. The expression of B7-H1 may have important therapeutic implications for the management of malignant pleural mesothelioma.

Original languageEnglish (US)
Pages (from-to)1036-1040
Number of pages5
JournalJournal of Thoracic Oncology
Issue number7
StatePublished - Jul 2014


  • B7-H1
  • Immunology
  • Mesothelioma
  • PD-L1
  • Sarcomatoid

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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