Clinical performance of endobronchial ultrasound‐guided transbronchial needle aspiration for assessing programmed death ligand‐1 expression in nonsmall cell lung cancer

Biswas, Abhishek; Leon, Marino E.; Drew, Peter A.; Fernández-Bussy, Sebastián; Furtado, Larissa V.; Jantz, Michael A.; Mehta, Hiren J.

doi:10.1002/dc.23900

Cited by 41 publications

(37 citation statements)

References 20 publications

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“…We observed a high concordance of PD-L1 expression when cell blocks contained a greater number of viable tumor cells. Similar to our results, previous studies have also shown improved consistency of PD-L1 expression between EBUS-TBNA and biopsy specimens with increased tumor cell count [27] and cell blocks containing greater than 100 tumor cells would have satisfactory PD-L1 staining results [28]. Our study further investigated the threshold for cell block specimens to serve as a suitable surrogate for PD-L1 staining, which showed that a high rate of concordance was achieved with cutoff of tumor cells set (28-8: TC ≥400; SP142: TC ≥500).…”

Section: Discussionsupporting

confidence: 91%

Cell Block as a Surrogate for Programmed Death-Ligand 1 Staining Testing in Patients of Non-Small Cell Lung Cancer

Dong

Liu²,

Jiang³

et al. 2020

J. Cancer

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Introduction: Programmed death-ligand 1 (PD-L1) staining is used in clinical practice to guide the proper use of immune checkpoint inhibitors. This study aimed to investigate the accuracy of PD-L1 staining of non-small cell lung cancer (NSCLC) cytological cell block samples. Methods: Paired cytological cell block and surgical resection samples were consecutively collected from January 2016 to February 2017 in Shanghai Pulmonary Hospital, Tongji University. Two trial-validated PD-L1 assays (28-8 and SP142) were used to quantify PD-L1 expression. Results: A total of 112 pairs of specimens were collected, including 68(60.7%) adenocarcinomas and 28(25.0%) squamous cell carcinomas. Based on a tumor proportion score (TPS) cutoff of 1% for the 28-8 and SP142 assays, PD-L1 expression was positive in 78.6% and 58.9% of surgical samples respectively, while PD-L1 expression was positive in 67.9% and 25.0% of cytological cell block samples. Based on staining by each antibody, fair to substantial concordance of PD-L1 expression was observed for cytological cell block specimens as compared to surgical resection ( ranges from 0.377 to 0.686). However, as the tumor cells in the cell block specimen increased, the consistency of PD-L1 expression increased. The concordance of PD-L1 expression in cell blocks with abundant cellularity was nearly perfect with various cutoffs (28-8: tumor cells over 400; SP142: tumor cells over 500). Conclusion: Cytological cell block specimens may serve as a surrogate for PD-L1 staining in patients of NSCLC when more than 400-500 cancer cells were contained (over 400 cancer cells for 28-8, over 500 cancer cells for SP142).

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Section: Discussionsupporting

confidence: 91%

Cell Block as a Surrogate for Programmed Death-Ligand 1 Staining Testing in Patients of Non-Small Cell Lung Cancer

Dong

Liu²,

Jiang³

et al. 2020

J. Cancer

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“…Similarly, diagnostic yield per puncture of histological specimens obtained using the SS needle in this study (58.7%) was consistent with that reported in previous reports (57%-61.3%) [12,13]. Recent studies have shown that the specimens obtained by EBUS-TBNA are tolerable for genetic analysis, such as next generation sequencing, and immunohistochemical analysis for programmed death ligand 1 [17][18][19][20]. Obtaining proper samples with higher diagnostic yield adequate for these additive critical testing for diagnosis and treatment would be considerably beneficial, therefore, improved sampling by modifying EBUS-TBNA needles maybe clinically helpful.…”

Section: Discussionsupporting

confidence: 90%

Utility and safety of cobalt chromium needles for endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective single-center study

Uchimura¹,

Yamasaki²,

Hara³

et al. 2019

Preprint

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard method for obtaining specimens of mediastinal and hilar lesions, and several types of needle of various sizes and materials are available. This study aimed to compare the utility and safety of two needles, cobalt chromium (CC) and stainless steel (SS), for EBUS-TBNA. Methods: This retrospective study included data of patients who underwent EBUS-TBNA with a 22-gauge needle made from either SS (38 patients, 121 punctures) or CC (39 patients, 145 punctures), and procedure time, histological data, complication rates were compared. Results: There were no significant differences between the groups in the baseline characteristics of the patients or lesions or in the complication rates. Although diagnostic yields in each patient who underwent EBUS-TBNA with the two needle types were similar, significantly shorter procedure time (22 min vs. 26 min, p = 0.007), diagnostic histologic sampling yield in each sample (71.0% vs. 58.7%, p = 0.039), fewer samples with cartilage alone (1.4% vs. 6.6%, p = 0.047) and fewer samples containing cartilage (7.6% vs. 16.5%, p = 0.034) were seen in the CC group compared with that in SS needle group. Conclusion: Compared with SS needles, CC needle for EBUS-TBNA showed significant shorter procedure time and higher ratio of getting diagnostic histological specimens in each sample. This might be because of better ability of CC needle to puncture through the trachea and bronchial cartilage to get appropriate lymph node sampling.

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“…Studies have evaluated the 22C3 PharmDx assay on the Dako autostainer platform, and the SP263 on the Ventana BenchMark Ultra . Skov et al demonstrated excellent concordance (95%) between the 22C3 and 28‐8 clones on the Dako autostainer on CBs.…”

Section: Predictive Icc In Lung Cancer Cytologymentioning

confidence: 99%

“…Overestimation of PD‐L1 positivity due to nonspecific cytoplasmic staining of background macrophages and inflammatory cells can occur in both CBs and smears and can be particularly challenging in effusion samples with predominantly singly lying tumor cells admixed with inflammatory cells and mesothelial cells . A confirmatory immunostain such as TTF‐1 and/or a pan‐leucocyte marker (eg, CD45) performed on a corresponding section will aid in confirmation of tumor cells for scoring of PD‐L1 positivity …”

Section: Predictive Icc In Lung Cancer Cytologymentioning

confidence: 99%

Immunocytochemistry for predictive biomarker testing in lung cancer cytology

Jain

Nambirajan

Borczuk

et al. 2019

Cancer Cytopathology

114

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With an escalating number of predictive biomarkers emerging in non-small cell lung carcinoma (NSCLC), immunohistochemistry (IHC) is being used as a rapid and cost-effective tool for the screening and detection of many of these markers.In particular, robust IHC assays performed on formalin-fixed, paraffin-embedded (FFPE) tumor tissue are widely used as surrogate markers for ALK and ROS1 rearrangements and for detecting programmed death ligand 1 (PD-L1) expression in patients with advanced NSCLC; in addition, they have become essential for treatment decisions. Cytology samples represent the only source of tumor in a significant proportion of patients with inoperable NSCLC, and there is increasing demand for predictive biomarker testing on them. However, the wide variation in the types of cytology samples and their preparatory methods, the use of alcohol-based fixatives that interfere with immunochemistry results, the difficulty in procurement of cytology-specific controls, and the uncertainty regarding test validity have resulted in underutilization of cytology material for predictive immunocytochemistry (ICC), and most cytopathologists limit such testing to FFPE cell blocks (CBs). The purpose of this review is to: 1) analyze various preanalytical, analytical, and postanalytical factors influencing ICC results; 2) discuss measures for validation of ICC protocols; and 3) summarize published data on predictive ICC for ALK, ROS1, EGFR gene alterations and PD-L1 expression on lung cancer cytology. Based on our experience and from a review of the literature, we conclude that cytology specimens are in principal suitable for predictive ICC, but proper optimization and rigorous quality control for high-quality staining are essential, particularly for non-CB preparations.

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Clinical performance of endobronchial ultrasound‐guided transbronchial needle aspiration for assessing programmed death ligand‐1 expression in nonsmall cell lung cancer

Abstract: EBUS TBNA is effective and has a high proportion of satisfactory results for testing PD-L1 expression on tumor cells in addition to NGS and ALK FISH.

Cited by 41 publications

References 20 publications

Cell Block as a Surrogate for Programmed Death-Ligand 1 Staining Testing in Patients of Non-Small Cell Lung Cancer

Cell Block as a Surrogate for Programmed Death-Ligand 1 Staining Testing in Patients of Non-Small Cell Lung Cancer

Utility and safety of cobalt chromium needles for endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective single-center study

Immunocytochemistry for predictive biomarker testing in lung cancer cytology

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