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PD-L1 Testing for Lung Cancer in 2019: Perspective from the IASLC Pathology Committee
Journal of Thoracic Oncology ( IF 20.4 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.jtho.2019.12.107
Sylvie Lantuejoul , Ming Sound-Tsao , Wendy A. Cooper , Nicolas Girard , Fred R. Hirsch , Anja C. Roden , Fernando Lopez-Rios , Deepali Jain , Teh-Ying Chou , Noriko Motoi , Keith M. Kerr , Yasushi Yatabe , Elisabeth Brambilla , John Longshore , Mauro Papotti , Lynette M. Sholl , Erik Thunnissen , Natasha Rekhtman , Alain Borczuk , Lukas Bubendorf , Yuko Minami , Mary Beth Beasley , Johan Botling , Gang Chen , Jin-Haeng Chung , Sanja Dacic , David Hwang , Dongmei Lin , Andre Moreira , Andrew G. Nicholson , Masayuki Noguchi , Giuseppe Pelosi , Claudia Poleri , William Travis , Akihiko Yoshida , Jillian B. Daigneault , Ignacio I. Wistuba , Mari Mino-Kenudson

The recent development of immune checkpoint inhibitors (ICI) has led to promising advances in the treatment of non-small cell and small cell lung cancer patients with advanced or metastatic disease. Most of ICI target the PD-1/PD-L1 axis with the aim of restoring anti-tumor immunity. Multiple clinical trials for ICI have examined a predictive value of PD-L1 protein expression in tumor cells and/or tumor-infiltrating immune cells by immunohistochemistry (IHC), for which different assays with specific IHC platforms were applied. Of those, some PD-L1 IHC assays have been validated for the prescription of the corresponding agent for first- or second-line treatment. However, not all laboratories are equipped with the dedicated platforms and many laboratories have set up in-house or laboratory developed tests, which are more affordable than generally expensive clinical trial-validated assays. Although PD-L1 IHC test is now deployed in the most pathology laboratories, its appropriate implementation and interpretation are critical as a predictive biomarker and can be challenging due to the multiple antibody clones and platforms or assays available and given the typically small size of samples provided. As many articles have been published since the issue of the IASLC Atlas of PD-L1 immunohistochemistry testing in lung cancer, this review by the IASLC pathology committee provides updates on the indications of ICI for lung cancer in 2019, and discusses important considerations on pre-analytical, analytical and post-analytical aspects of PD-L1 IHC testing, including specimen type, validation of assays, external quality assurance and training.

中文翻译:

2019 年肺癌 PD-L1 检测:来自 IASLC 病理学委员会的观点

免疫检查点抑制剂 (ICI) 的最新发展在治疗患有晚期或转移性疾病的非小细胞和小细胞肺癌患者方面取得了有希望的进展。大多数 ICI 靶向 PD-1/PD-L1 轴,目的是恢复抗肿瘤免疫。ICI 的多项临床试验通过免疫组织化学 (IHC) 检查了肿瘤细胞和/或肿瘤浸润免疫细胞中 PD-L1 蛋白表达的预测价值,为此应用了具有特定 IHC 平台的不同检测方法。其中,一些 PD-L1 IHC 检测已被验证可用于一线或二线治疗的相应药物处方。然而,并非所有实验室都配备了专用平台,许多实验室已经建立了内部或实验室开发的测试,比通常昂贵的临床试验验证分析更实惠。尽管 PD-L1 IHC 测试现在已部署在大多数病理实验室中,但其适当的实施和解释作为预测性生物标志物至关重要,并且由于可用的多种抗体克隆和平台或检测方法以及所提供的样本通常较小,因此可能具有挑战性. 由于自 IASLC 肺癌 PD-L1 免疫组化检测图谱发布以来已经发表了许多文章,IASLC 病理学委员会的这篇综述提供了 2019 年肺癌 ICI 适应症的最新信息,并讨论了在肺癌前的重要考虑因素。 PD-L1 IHC 测试的分析、分析和分析后方面,包括样本类型、检测验证、外部质量保证和培训。
更新日期:2020-04-01
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