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Schlosser P, Schiwitza A, Klaus J, Hieke-Schulz S, Szic KSV, Duyster J, Trepel M, Zirlik K, Schumacher M, Claus R. Conditional survival to assess prognosis in patients with chronic lymphocytic leukemia. Ann Hematol 2024; 103:1613-1622. [PMID: 38308707 PMCID: PMC11009732 DOI: 10.1007/s00277-024-05627-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/13/2024] [Indexed: 02/05/2024]
Abstract
Biomarkers in chronic lymphocytic leukemia (CLL) allow assessment of prognosis. However, the validity of current prognostic biomarkers based on a single assessment point remains unclear for patients who have survived one or more years. Conditional survival (CS) studies that address how prognosis may change over time, especially in prognostic subgroups, are still rare. We performed CS analyses to estimate 5-year survival in 1-year increments, stratified by baseline disease characteristics and known risk factors in two community-based cohorts of CLL patients (Freiburg University Hospital (n = 316) and Augsburg University Hospital (n = 564)) diagnosed between 1984 and 2021. We demonstrate that 5-year CS probability is stable (app. 75%) for the entire CLL patient cohort over 10 years. While age, sex, and stage have no significant impact on CS, patients with high-risk disease features such as non-mutated IGHV, deletion 17p, and high-risk CLL-IPI have a significantly worse prognosis at diagnosis, and 5-year CS steadily decreases with each additional year survived. Our results confirm that CLL patients have a stable survival probability with excess mortality and that the prognosis of high-risk CLL patients declines over time. We infer that CS-based prognostic information is relevant for disease management and counseling of CLL patients.
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Affiliation(s)
- Pascal Schlosser
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Centre for Integrative Biological Signalling Studies (CIBSS), University of Freiburg, Freiburg, Germany
| | - Annett Schiwitza
- Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Jonas Klaus
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
| | - Stefanie Hieke-Schulz
- Institute of Medical Biometry and Medical Informatics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - Katarzyna Szarc Vel Szic
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Trepel
- Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Katja Zirlik
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
- Tumor- Und BrustZentrum Ostschweiz, Chur, Switzerland
| | - Martin Schumacher
- Institute of Medical Biometry and Medical Informatics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Rainer Claus
- Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany.
- Pathology, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
- Faculty of Medicine, Comprehensive Cancer Center, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
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Weber MS, Buttmann M, Meuth SG, Dirks P, Muros-Le Rouzic E, Eggebrecht JC, Hieke-Schulz S, Leemhuis J, Ziemssen T. Safety, Adherence and Persistence in a Real-World Cohort of German MS Patients Newly Treated With Ocrelizumab: First Insights From the CONFIDENCE Study. Front Neurol 2022; 13:863105. [PMID: 35614917 PMCID: PMC9126090 DOI: 10.3389/fneur.2022.863105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Real-world relapsing multiple sclerosis (RMS) and primary progressive MS (PPMS) populations may be more diverse than in clinical trials. Here, we present a first analysis of safety, adherence and persistence data from a real-world cohort of patients newly treated with ocrelizumab. Methods CONFIDENCE (ML39632, EUPAS22951) is an ongoing multicenter, non-interventional post authorization safety study assessing patients with RMS or PPMS newly treated with ocrelizumab or other disease-modifying therapies for up to 10 years. For this analysis, patients newly treated with ocrelizumab were analyzed in subgroups by MS phenotype and age over a mean ~1 year of exposure totaling 2,329 patient years [PY]). Results At data cutoff (14 October 2020), 1,702 patients with RMS and 398 patients with PPMS were treated with ≥1 dose of ocrelizumab. At baseline, the mean ages (SD) of patients with RMS and PPMS were 41.59 (11.24) and 50.95 (9.88) years and the mean EDSS (Expanded Disability Status Scale) was 3.18 (1.87) and 4.41 (1.59), respectively. The most common adverse events (AEs) and serious AEs across both phenotypes were infections and infestations, with infection SAE rates of 2.8 events/100 PY and 1.5 events/100 PY in patients with RMS and PPMS, respectively. Across all phenotypes, ocrelizumab persistence was 92% at 24 months; median time between doses was ~6 months. Conclusions The ocrelizumab safety profile observed in the CONFIDENCE real-world MS population was consistent to the one observed in pivotal clinical trials. High treatment persistence and adherence were observed. Trial Registration ML39632, EUPAS22951
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Affiliation(s)
- Martin S Weber
- Department of Neurology, Institute of Neuropathology, University Medicine Göttingen, Göttingen, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Göttingen, Germany
| | | | - Sven G Meuth
- Clinic of Neurology, Heinrich-Heine University, Düsseldorf, Germany
| | - Petra Dirks
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | | | | | | | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Neurological Clinic, Carl Gustav Carus University Clinic, University of Technology, Dresden, Germany
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Noske A, Ammann JU, Wagner DC, Denkert C, Lebeau A, Sinn P, Kreipe HH, Sommer U, Baretton G, Steiger K, Kiechle M, Hieke-Schulz S, Flores M, Roth W, Weichert W. A multicentre analytical comparison study of inter-reader and inter-assay agreement of four programmed death-ligand 1 immunohistochemistry assays for scoring in triple-negative breast cancer. Histopathology 2020; 78:567-577. [PMID: 32936950 DOI: 10.1111/his.14254] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/09/2020] [Indexed: 12/17/2022]
Abstract
AIMS Studies in various cancer types have demonstrated discordance between results from different programmed death-ligand 1 (PD-L1) assays. Here, we compare the reproducibility and analytical concordance of four clinically developed assays for assessing PD-L1-positivity in tumour-infiltrating immune cells in the tumour area (PD-L1-IC-positivity) in triple-negative breast cancer (TNBC). METHODS AND RESULTS Primary TNBC resection specimens (n = 30) were selected based on their PD-L1-IC-positivity per VENTANA SP142 (<1%: 15 cases; 1-5%: seven cases; >5%: eight cases). Serial histological sections were stained for PD-L1 using VENTANA SP142, VENTANA SP263, DAKO 22C3 and DAKO 28-8. PD-L1-IC-positivity and tumour cell expression (≥1 versus <1%) were scored by trained readers from seven sites using online virtual microscopy. The adjusted mean of PD-L1-IC-positivity for SP263 (7.8%) was significantly higher than those for the other three assays (3.7-4.9%). Differences in adjusted means were statistically significant between SP263 and the other three assays (P < 0.0001) but not between the three remaining assays when excluding SP263 (P = 0.0961-0.6522). Intra-class correlation coefficients revealed moderate-to-strong inter-reader agreement for each assay (0.460-0.805) and poor-to-strong inter-assay agreement for each reader (0.298-0.678) on PD-L1-IC-positivity. CONCLUSIONS In this first multicentre study of different PD-L1 assays in TNBC, we show that PD-L1-IC-positivity for SP142, 22C3 and 28-8 was reproducible and analytically concordant, indicating that these three assays may be analytically interchangeable. The relevance of the higher PD-L1-IC-positivity for SP263 should be further investigated.
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Affiliation(s)
- Aurelia Noske
- Technical University of Munich, Institute of Pathology, Munich, Germany
| | | | - Daniel-Christoph Wagner
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital of Giessen and Marburg, Marburg, Germany
| | - Annette Lebeau
- Private Group Practice for Pathology Lübeck, Lübeck, Germany.,Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Sinn
- Division of Gynecopathology, University Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ulrich Sommer
- Institute of Pathology, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Gustavo Baretton
- Institute of Pathology, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Katja Steiger
- Technical University of Munich, Institute of Pathology, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Mike Flores
- Ventana Medical Systems, Inc., Tucson, AZ, USA
| | - Wilfried Roth
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wilko Weichert
- Technical University of Munich, Institute of Pathology, Munich, Germany
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van Hall V, Hartung H, Dirks P, Eggebrecht J, Hieke-Schulz S, Leemhuis J, Wormser D, Ziemssen T. P23 Assessing the Long-term Outcomes of Ocrelizumab Treatment in Germany – CONFIDENCE Baseline Characteristics. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dirks P, Zingler V, Leemhuis J, Berthold H, Hieke-Schulz S, Wormser D, Ziemssen T. Design of a non-interventional post-marketing study to assess the long-term safety and effectiveness of ocrelizumab in German real world multiple sclerosis cohorts - the CONFIDENCE study protocol. BMC Neurol 2020; 20:95. [PMID: 32171264 PMCID: PMC7071560 DOI: 10.1186/s12883-020-01667-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disease that requires lifelong treatment. A highly effective drug not only for relapsing but also for progressive forms of MS with a favorable safety profile is needed to further improve overall patient outcomes. Ocrelizumab, a recombinant humanized monoclonal antibody that selectively targets CD20-expressing B-cells, is the first drug indicated for the treatment of adult patients with relapsing forms of MS (RMS) and primary progressive MS (PPMS). Its safety and effectiveness profile has yet to be studied in a large, real-world setting. CONFIDENCE aims to further characterize the safety profile of ocrelizumab in routine clinical practice. In addition, real-world effectiveness data will be collected to complement the efficacy data documented in the pivotal clinical trials. METHODS CONFIDENCE is a non-interventional, prospective, multicenter, long-term study collecting primary data from 3000 RMS and PPMS patients newly treated with ocrelizumab and 1500 patients newly treated with other selected MS disease-modifying therapies (DMTs). Treatment must be in accordance with the local label and follow routine practice. Data will be collected at approximately 250 neurological centers and practices across Germany. The recruitment period of 30 months started in April 2018. The observation period per patient is planned 7.5 to 10 years, depending on the date of inclusion, regardless of whether patients discontinue treatment. Visits follow routine practice and will be documented approximately every 6 months. The primary endpoint is the incidence and type of uncommon adverse events and death. Statistical analyses will be mainly descriptive and exploratory. DISCUSSION CONFIDENCE is a large, non-interventional, post-authorization safety study that assesses long-term safety and effectiveness of ocrelizumab and other DMTs in a real-world setting. Data collected in CONFIDENCE will also be integrated into studies that have been developed to fulfil international regulatory requirements.
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Affiliation(s)
- Petra Dirks
- Roche Pharma AG, Emil-Barell-Straße 1, 79639, Grenzach-Wyhlen, Germany
| | - Vera Zingler
- F. Hoffmann-La Roche Ltd, Grenzacherstraße 124, 4070, Basel, Switzerland
| | - Jost Leemhuis
- Roche Pharma AG, Emil-Barell-Straße 1, 79639, Grenzach-Wyhlen, Germany
| | - Heike Berthold
- Roche Pharma AG, Emil-Barell-Straße 1, 79639, Grenzach-Wyhlen, Germany
| | | | - David Wormser
- F. Hoffmann-La Roche Ltd, Grenzacherstraße 124, 4070, Basel, Switzerland
| | - Tjalf Ziemssen
- Universitätsklinikum Carl Gustav Carus, Zentrum für klinische Neurowissenschaften, Fetscherstr. 74, 01307, Dresden, Germany.
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Mäurer M, Tiel-Wilck K, Oehm E, Richter N, Springer M, Oschmann P, Manzel A, Hieke-Schulz S, Zingler V, Kandenwein JA, Ziemssen T, Linker RA. Reasons to switch: a noninterventional study evaluating immunotherapy switches in a large German multicentre cohort of patients with relapsing-remitting multiple sclerosis. Ther Adv Neurol Disord 2019; 12:1756286419892077. [PMID: 31903096 PMCID: PMC6923693 DOI: 10.1177/1756286419892077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 10/22/2019] [Indexed: 01/05/2023] Open
Abstract
Background: With a large array of disease modifying therapies (DMTs) for
relapsing-remitting MS (RRMS), identifying the optimal treatment option for
the individual patient is challenging and switching of immunotherapies is
often required. The objective of this study was to systematically
investigate reasons for DMT switching in patients on immunotherapies for
mild/moderate MS, and provide real-life insights into currently applied
therapeutic strategies. Methods: This noninterventional, cross-sectional study (ML29913) at 50 sites in
Germany included RRMS patients on therapies for mild/moderate MS who
switched immunotherapy in the years 2014–2017. The key outcome variable was
the reason to switch, as documented in the medical charts, based on failure
of current therapy, cognitive decline, adverse events (AEs), patient wish,
or a woman’s wish to become pregnant. Expectations of the new DMT and
patients’ assessment of the decision maker were also recorded. Results: The core analysis population included 595 patients, with a mean age of
41.6 years, of which 69.7% were female. More than 60% of patients had at
least one relapse within 12 months prior to the switch. The main reasons to
switch DMT were failure of current therapy (53.9%), patient wish (22.4%),
and AEs (19.0%). Most patients (54.3%) were switched within DMTs for
mild/moderate MS; only 43.5% received a subsequent DMT for active/highly
active MS. While clinical and outcome-oriented aspects were the most
frequently mentioned expectations of the new DMT for physicians, aspects
relating to quality of life played a major role for patients. Conclusions: Our data indicate suboptimal usage of DMTs, including monoclonal antibodies,
for active/highly active MS in German patients. This illustrates the medical
need for DMTs combining high efficacy, low safety risk, and low therapy
burden.
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Affiliation(s)
- Mathias Mäurer
- Klinikum Würzburg Mitte, Standort Juliusspital, Würzburg, Germany
| | | | - Eckard Oehm
- Group practice for Neurology, Psychiatry and Psychotherapy, Freiburg, Germany
| | - Nils Richter
- Group practice for Neurology, Düsseldorf, Germany
| | | | | | | | | | | | | | - Tjalf Ziemssen
- Universitätsklinikum Carl Gustav Carus, Centre for Clinical Neuroscience, Dresden, Germany
| | - Ralf A Linker
- Neurologische Klinik der Universität Regensburg, Universitätsstraße 84, Regensburg, 93053, Germany
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Noske A, Ammann J, Wagner DC, Denkert C, Lebeau A, Sinn P, Kreipe HH, Baretton G, Steiger K, Kiechle M, Hieke-Schulz S, Roth W, Weichert W. Reproducibility and concordance of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays in triple negative breast cancer (TNBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schwamborn K, Ammann JU, Knüchel R, Hartmann A, Baretton G, Lasitschka F, Schirmacher P, Braunschweig T, Tauber R, Erlmeier F, Hieke-Schulz S, Weichert W. Multicentric analytical comparability study of programmed death-ligand 1 expression on tumor-infiltrating immune cells and tumor cells in urothelial bladder cancer using four clinically developed immunohistochemistry assays. Virchows Arch 2019; 475:599-608. [PMID: 31267201 PMCID: PMC6861354 DOI: 10.1007/s00428-019-02610-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
Programmed death-ligand 1 (PD-L1) expression on tumor cells (TC) or tumor-infiltrating immune cells (IC) correlated in several studies with PD-L1/programmed death-1 (PD-1) checkpoint inhibitor efficacy. Since June 2018, a positive PD-L1 status is required for atezolizumab or pembrolizumab treatment of patients with advanced or metastasized urothelial bladder cancer, who are ineligible for cisplatin-containing therapy. We examined technical comparability and inter-reader agreement of four clinically developed PD-L1 assays in locally advanced disease. Archived, formalin-fixed, paraffin-embedded sections from 30 patients (73.3% cystectomies, 26.7% transurethral resections) were stained by PD-L1 immunohistochemistry using VENTANA SP142, VENTANA SP263, DAKO 22C3, and DAKO 28-8 at two sites per manufacturers’ protocols and scored blinded at five sites for PD-L1 expression on IC (% per tumor area) and TC (%). Small, non-significant inter-assay differences were observed for IC. For TC, SP142 showed significantly lower staining percentages. Pairwise comparisons revealed − 0.3 to 1.6% differences in adjusted means between assays for IC, and for TC, − 10.5 to − 7.8% (SP142 versus others) and − 1.9 to 2.7% (other comparisons). Inter-reader and inter-assay agreement was moderate to high for both IC and TC. Allocation to binary cutoffs (1%, 5%, 10%) showed substantial to high Kappa agreement scores (0.440–0.923) for IC and TC between assays for each reader. This first multicenter study, with five independent readers blinded with respect to the assay used, suggests that all four currently clinically relevant assays are analytically similar for evaluation of PD-L1-stained IC and three (SP263, 22C3, and 28-8) for PD-L1-stained TC. Inter-observer agreement for trained readers in scoring of both IC and TC positivity was generally high.
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Affiliation(s)
- Kristina Schwamborn
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675, Munich, Germany.
| | | | - Ruth Knüchel
- Institute of Pathology, Uniklinik RWTH Aachen, Aachen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gustavo Baretton
- Institute of Pathology, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Felix Lasitschka
- Institute of Pathology, Universitätsklinikum Heidelberg, Heidelberg, Germany
- Institut für Pathologie, Dres. med., Kaufmann und Wilke, Industriestr 11c, 67063, Ludwigshafen, Germany
| | - Peter Schirmacher
- Institute of Pathology, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Robert Tauber
- Department of Urology, Technische Universität München, Munich, Germany
| | - Franziska Erlmeier
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675, Munich, Germany
| | | | - Wilko Weichert
- Institute of Pathology, Technische Universität München and Member of the German Cancer Consortium (DKTK), Partner site München, Munich, Germany
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Sommer U, Eckstein M, Ammann J, Braunschweig T, Macher-Goeppinger S, Schwamborn K, Hieke-Schulz S, Wullich B, Wirth M, Roth W, Knüchel R, Weichert W, Baretton G, Hartmann A. Abstract 4037: Analytical and inter-observer comparability of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry assays in advanced clear cell renal cell carcinoma (CCRCC). Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PD-L1/programmed cell death-1 (PD-1)-targeting checkpoint inhibitors have shown clinical activity in advanced and metastatic RCC, which correlates with PD-L1 expression on tumor cells (TC) and/or tumor-infiltrating immune cells (IC). We examined the analytical performance and inter-observer agreement of 4 clinically developed assays for PD-L1 expression on IC and TC in locally advanced CCRCC.
Methods: Archived formalin-fixed paraffin-embedded nephrectomy specimens from 30 patients with locally advanced (T2a+) CCRCC were selected from 201 cases based on PD-L1 status per VENTANA SP142 (IC <1%, 1-5%, or >5%; 10 cases each). All selected cases were stained for PD-L1 using VENTANA SP142 and SP263, and DAKO 22C3 and 28-8, each at one site, according to manufacturer protocols. Stainings were blinded with respect to both assay and sample information and scored at 5 sites for PD-L1 expression on IC (% per tumor area) and TC (% of tumor cells). All readers had been trained in scoring IC per tumor area.
Results: Adjusted means of IC staining for PD-L1 varied from 4.00 to 4.90%, and TC from 1.32 to 10.68%, depending on the assay used (Table). Pairwise comparisons of adjusted means between assays revealed small, non-significant differences for IC (-0.9 to 0.3%), while for TC there were significant differences for SP142 v other assays (-9.4 to -5.7%) and for SP263 v 28-8 (-3.7%), and small, non-significant differences for other comparisons (-2.9 to -0.8%). The pre-specified allocation to binary cutoffs (1% or 5%) for IC or TC alone predominantly showed moderate-to-substantial Kappa agreement scores (0.4 to 0.8) for IC and TC between assays for each reader.
Conclusions: This is the first multicenter analytical comparison study of PD-L1 assays in CCRCC. Good-to-high concordance rates across all assays were achieved between trained readers for scoring PD-L1 on IC and for some assays for PD-L1 on TC.
AssayPD-L1 on IC, % (95% CI)*Reader ICC†PD-L1 on TC, % (95% CI)*Reader ICC†VENTANA SP1424.10 (3.33 to 4.86)0.7251.32 (-2.14 to 4.79)0.142VENTANA SP2634.26 (3.49 to 5.02)0.4946.98 (3.52 to 10.45)0.823DAKO 22C34.00 (3.23 to 4.76)0.7019.87 (6.41 to 13.34)0.758DAKO 28-84.90 (4.14 to 5.60)0.42210.68 (7.21 to 14.14)0.778* Sample adjusted means for each assay; † Intra-class correlation per assay between 5 readers.
Citation Format: Ulrich Sommer, Markus Eckstein, Johannes Ammann, Till Braunschweig, Stephan Macher-Goeppinger, Kristina Schwamborn, Stefanie Hieke-Schulz, Bernd Wullich, Manfred Wirth, Wilfried Roth, Ruth Knüchel, Wilko Weichert, Gustavo Baretton, Arndt Hartmann. Analytical and inter-observer comparability of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry assays in advanced clear cell renal cell carcinoma (CCRCC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4037.
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Affiliation(s)
- Ulrich Sommer
- 1Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Markus Eckstein
- 2University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | | | | | | | | | - Bernd Wullich
- 2University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Manfred Wirth
- 1Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden, Germany
| | | | | | | | - Gustavo Baretton
- 1Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Arndt Hartmann
- 2University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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