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Kim SY, Kim TE, Park CK, Yoon HK, Sa YJ, Kim HR, Woo IS, Kim TJ. Comprehensive Comparison of 22C3 and SP263 PD-L1 Expression in Non-Small-Cell Lung Cancer Using Routine Clinical and Conditioned Archives. Cancers (Basel) 2022; 14:cancers14133138. [PMID: 35804910 PMCID: PMC9265108 DOI: 10.3390/cancers14133138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 12/10/2022] Open
Abstract
PD-L1 harmonization studies revealed a strong correlation between the 22C3 and SP263 assays in non-small-cell lung cancer (NSCLC). However, the assays’ characteristics have yet to be validated in a variety of clinical and analytical settings. The results of 431 NSCLC samples tested concurrently in routine clinical practice with the PD-L1 22C3 and SP263 assays were reviewed, and both assays were performed on 314 archives of surgically resected NSCLCs to assess PD-L1 expression in relation to variables such as FFPE block age and FFPE section storage condition. In routine clinical samples, 22C3 showed the highest concordance rate with 94.5% of SP263 tumor proportion score (TPS) ≥50% and 92.3% of SP263 TPS ≥1%, while SP263 showed a concordance rate with 79.6% of 22C3 TPS ≥50% and 89.9% of 22C3 TPS ≥1%. In the archival analysis, the high TPS of 22C3 and SP263 (versus TPS 1%) were significantly associated with a more recent block (<3 years versus ≥3 years) (p = 0.007 and p = 0.009, respectively). Only the TPS of 22C3 was reduced when FFPE sections were stored at room temperature compared to SP263. However, when stored at 4 °C, the storage duration had no effect on expression in either assay. For 22C3 TPS 1−49 percent and ≥50 percent (OR = 1.73, p = 0.006 and OR = 1.98, p = 0.002, respectively). There was a considerably larger chance of preserved 22C3 expression in recent room-temperature paraffin section storage, although SP263 demonstrated preserved expression in prolonged room-temperature section storage. Despite the good association between PD-L1 22C3 and SP263 in routine clinical samples, FFPE blocks older than 3 years and sections held at room temperature for more than 1 week may result in an underestimation of PD-L1 status, particularly for the 22C3 test. However, the SP263 assay was more sensitive under these conditions.
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Affiliation(s)
- Sue Youn Kim
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Tae-Eun Kim
- Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea;
| | - Chan Kwon Park
- Division of Pulmonology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea; (C.K.P.); (H.-K.Y.)
| | - Hyoung-Kyu Yoon
- Division of Pulmonology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea; (C.K.P.); (H.-K.Y.)
| | - Young Jo Sa
- Department of Thoracic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea;
| | - Hyo Rim Kim
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea;
| | - In Sook Woo
- Department of Medical Oncology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea;
| | - Tae-Jung Kim
- Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea;
- Correspondence: ; Tel.: +82-2-3779-2157
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Gagné A, Orain M, Ionescu D, Tsao MS, Joubert D, Joubert P. Comprehensive assessment of PD-L1 immunohistochemistry on paired tissue and cytology specimens from non-small cell lung cancer. Lung Cancer 2020; 146:276-284. [PMID: 32593917 DOI: 10.1016/j.lungcan.2020.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES PD-L1 staining assessed by immunohistochemistry (IHC) is a predictive biomarker used to select advanced stage non-small cell lung carcinoma (NSCLC) patients who are likely to respond to PD-1/PD-L1 inhibitors. Cytology specimens represent a significant percentage of the diagnostic samples and additional data are required to show that they provide reliable PD-L1 results when compared to tissue specimens. We aimed to compare PD-L1 staining obtained from patient-matched tissue and cytology specimens. We also want to assess the feasibility of PD-L1 testing on cell blocks with two assays by evaluating the intra- and inter-observer agreement and the level of difficulty for determining the percentage of stained tumor cells (TPS). MATERIALS AND METHODS Forty-six patients with NSCLC were selected. Each patient provided a surgical specimen and a cytology sample (cell block) and/or a biopsy at diagnosis. PD-L1 staining using Agilent PD-L1 IHC 28-8 pharmDx and VENTANA PD-L1 (SP263) assays was evaluated by four pathologists using the TPS. Sixty slides were rescored to document intra-observer agreement. Pathologists were asked to score the level of difficulty for evaluating PD-L1 TPS for each slide. Fleiss's and Cohen's kappas (k) were used to assess the agreement between paired specimens as well as intra- and inter-observer agreement. RESULTS The concordance in PD-L1 TPS between cell blocks and surgical specimens (k varying from 0.56 to 0.82) or biopsies (k from 0.43 to 0.81) was moderate to substantial, depending on the cut-off. On cell blocks, inter-observer agreement was substantial (k from 0.74 to 0.82) and intra-observer agreement was almost perfect (k from 0.85 to 0.93). The perceived difficulty of PD-L1 evaluation of cell blocks was not different from surgical specimens but more difficult than biopsy samples. CONCLUSION PD-L1 TPS was concordant between cell blocks and tissue specimens, mainly at 10, 25 and 50 % cut-offs. PD-L1 evaluation on cell blocks was feasible and reproducible between different observers and assays.
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Affiliation(s)
- Andréanne Gagné
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
| | - Michèle Orain
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
| | - Diana Ionescu
- British Columbia Cancer Agency, Department of Pathology, Vancouver, Canada.
| | - Ming-Sound Tsao
- University Health Network, Princess Margaret Cancer Centre, Department of Pathology, Toronto, Canada.
| | - David Joubert
- University of Ottawa, Faculty of Social Sciences, Ottawa, Canada.
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
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Gagné A, Wang E, Bastien N, Orain M, Desmeules P, Pagé S, Trahan S, Couture C, Joubert D, Joubert P. Impact of Specimen Characteristics on PD-L1 Testing in Non-Small Cell Lung Cancer: Validation of the IASLC PD-L1 Testing Recommendations. J Thorac Oncol 2019; 14:2062-2070. [PMID: 31494258 DOI: 10.1016/j.jtho.2019.08.2503] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Molecules targeting programmed cell death 1 or its ligand programmed death ligand 1 (PD-L1) revolutionized the treatment of patients with NSCLC. The only approved biomarker for predicting treatment response is the PD-L1 tumor proportion score (TPS) determined by immunohistochemistry. According to International Association for the Study of Lung Cancer recommendations, specimens that include fewer than 100 tumor cells or are older than 3 years should not be used for PD-L1 testing and the reliability of cell blocks has yet to be validated. METHODS This retrospective study included 1249 consecutive patients with NSCLC who were tested for PD-L1 (using the clone 22C3) between September 2016 and April 2017. The associations between the presence of suboptimal characteristics (specimens with <100 tumor cells, specimens older than 3 years, or cell blocks) and PD-L1 TPS were examined by using a multinomial logistic regression. RESULTS Specimens from 35.5% of the patients had at least one suboptimal characteristic. For patients with a PD-L1 TPS of higher than 50%, there was a significantly higher probability that they had a specimen with more than 100 tumor cells (OR = 1.97, p = 0.008) and a more recent block (within 30 days versus after >3 years) (OR = 2.46, p = 0.023). There was no statistical difference in PD-L1 TPS between cell blocks and tissue specimens (biopsy OR = 0.99 [p = 0.996] and surgery OR = 0.73 [p = 0.302]). CONCLUSIONS Our results suggest that specimens containing fewer than 100 tumor cells or older than 3 years may lead to an underestimation of PD-L1 status. Our findings also provide support for the use of cell blocks for PD-L1 testing, although further research is needed.
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Affiliation(s)
- Andréanne Gagné
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada
| | - Emily Wang
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada
| | - Nathalie Bastien
- Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada
| | - Michèle Orain
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada
| | - Patrice Desmeules
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada; Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada
| | - Sylvain Pagé
- Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada
| | - Sylvain Trahan
- Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada; Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada
| | - Christian Couture
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada; Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada; Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada
| | - David Joubert
- Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - Philippe Joubert
- Quebec City Heart and Lung Institute Research Center, Quebec City, Canada; Department of Pathology, Quebec City Heart and Lung Institute, Quebec City, Canada; Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada.
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