Comparative analysis of programmed death ligand 1 expression in paired cytologic and histologic specimens of non–small cell lung cancer

Daverio, Matteo; Patrucco, Filippo; Gavelli, Francesco; Airoldi, Chiara; Sciortino, Giusy; Chiaramonte, Claudia; Rena, Ottavio; Balbo, Piero Emilio; Boldorini, Renzo

doi:10.1002/cncy.22292

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…Histologic FFPE tissue has traditionally served as the most widely used specimen preparation for PD-L1 testing, with limited studies on various cytologic preparations. Although several prior studies comparing PD-L1 expression via TPS between cytologic and histologic specimens have focused on non-small cell lung carcinoma (NSCLC), [16][17][18] the evaluation of the feasibility of PD-L1 IHC using CPS has not been well established in HNSCC cytologic samples.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of programmed death ligand 1 expression in cytology to determine eligibility for immune checkpoint inhibitor therapy in patients with head and neck squamous cell carcinoma

Liu

Williams

Stewart

et al. 2021

Cancer Cytopathology

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BACKGROUND:Immune checkpoint inhibitors targeting the programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway have recently emerged as a frontline treatment for head and neck squamous cell carcinoma (HNSCC). The evaluation of PD-L1 expression by immunohistochemistry in histologic samples is used to determine the eligibility of patients with HNSCC for immunotherapy. Patients with newly diagnosed HNSCC are frequently diagnosed by fine-needle aspiration (FNA) of lymph nodes with metastatic disease. However, the evaluation of PD-L1 expression with the proposed combined positive score (CPS) has not been well established in cytology specimens. METHODS: This study retrospectively identified 21 HNSCC patients with a known PD-L1 status from histologic specimens and matched FNA specimens with tumor cells on cell blocks (CBs). The CB sections were stained with a PD-L1 antibody (22C3 clone). All cases were scored with CPS and the tumor proportion score (TPS). RESULTS: The data showed substantial concordance between cytologic and histologic specimens for CPS (agreement, 76.2%; κ = 0.607) and TPS (agreement, 76.2%; κ = 0.607). With histology used as a reference standard, the positive predictive value was 100% for both CPS and TPS, whereas the negative predictive value was 57.1% for CPS assessments and 50% for TPS assessments. CONCLUSIONS: PD-L1 expression in HNSCC cytology samples has high concordance with paired histologic samples. PD-L1 CPS evaluation is feasible in HNSCC cytology CBs and can act as a surrogate for determining eligibility for immunotherapy in cases in which a histologic specimen is not readily available.

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Section: Discussionmentioning

confidence: 99%

Evaluation of programmed death ligand 1 expression in cytology to determine eligibility for immune checkpoint inhibitor therapy in patients with head and neck squamous cell carcinoma

Liu

Williams

Stewart

et al. 2021

Cancer Cytopathology

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“…Papanicolaou stain helps to identify areas of interest and, according to the manufacturer's specifications, do not require to be previously destained (14). Rapid-H&E destaining previously to immunohistochemistry is an alternative procedure (6). Lozano et al recommend using coverslipping film instead of a glass coverslip in order to shorten coverslip removal time and avoid hypothetical cell losses when removing crystal coverslip for performing ICC (14).…”

Section: Type Of Cytological Samples and Preanaliticsmentioning

confidence: 99%

“…Consequently, pathologists, mainly those dedicated to cytopathology, have no choice but to resort, implement, validate, and take advantages of cytological specimens for diagnosis and biomarker analysis. In this setting molecular cytopathology has become a significant player in the world of diagnosis and predictive pathology and a growing body of research is being dedicated to validate the feasibility of applying PDL-1 assays to cytological samples (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

PD-L1 in Cytological Samples: A Review and a Practical Approach

et al. 2021

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With a growing number of predictive biomarkers needed to manage patients with non-small cell lung cancer (NSCLC), there has been a paradigm shift in care and handling of diagnostic samples. Among the various testing methods, immunohistochemistry (IHC) is the most cost- effective and widely available. Furthermore, over the past decade immunotherapy has emerged as one of the most promising cancer treatments. In this scenario IHC is the most used testing method available for PDL-1/PD1 immunotherapy. Several monoclonal antibodies targeting programmed death 1 (PD-1)/programmed death ligand-1 (PD-L1) pathways have been integrated into standard-of-care treatments of a wide range of cancer types, once provided evidence of PD-L1 expression in tumor cells by immunohistochemistry (IHC). Since currently available PD-L1 assays have been developed on formalin-fixed paraffin embedded (FFPE) histological specimens, a growing body of research is being dedicated to confirm the feasibility of applying PDL-1 assays also to cytological samples. Albeit promising results have been reported, several important issues still need to be addressed. Among these are the type of cytological samples, pre-analytical issues, cyto-histological correlation, and inter-observer agreement. This review briefly summarizes the knowledge of the role of cytopathology in the analysis of PD-L1 by immunocytochemistry (ICC) and future directions of cytopathology in the immunotherapy setting.

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“…Studies analyzing PD‐L1 testing on lung carcinoma cytology specimens originated mostly from the USA, followed by publications arising from Italy, Canada, United Kingdom, China, Germany, Japan, India, Turkey and other countries. The Dako clone 22C3 was the most common clone analyzed on cytology specimens, followed by the Ventana SP263 clone 17–67 . The data collected included the clone type used in each study.…”

Section: Resultsmentioning

confidence: 99%

Program death ligand‐1 immunocytochemistry in lung cancer cytological samples: A systematic review

Satturwar

Girolami

Munari

et al. 2022

Diagnostic Cytopathology

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In this era of personalized medicine, targeted immunotherapies like immune checkpoint inhibitors (ICI) blocking the programmed death-1 (PD-1)/program death ligand-1 (PD-L1) axis have become an integral part of treating advanced stage non-small cell lung carcinoma (NSCLC) and many other cancer types. Multiple monoclonal antibodies are available commercially to detect PD-L1 expression in tumor cells by immunohistochemistry (IHC). As most clinical trials initially required tumor biopsy for PD-L1 detection by IHC, many of the currently available PD-1/PD-L1 assays have been developed and validated on formalin fixed tissue specimens. The majority (>50%) of lung cancer cases do not have a surgical biopsy or resection specimen available for ancillary testing and instead must rely primarily on fine needle aspiration biopsy specimens for diagnosis, staging and ancillary tests. Review of the literature shows multiple studies exploring the feasibility of PD-L1 IHC on cytological samples. In addition, there are studies addressing various aspects of IHC validation on cytology preparations including pre-analytical (e.g., different fixatives), analytical (e.g., antibody clone, staining platforms, inter and intra-observer agreement, cytology-histology concordance) and post-analytical (e.g., clinical outcome) issues. Although promising results in this field have emerged utilizing cytology samples, many important questions still need to be addressed. This review summarizes the literature of PD-L1 IHC in lung cytology specimens and provides practical tips for optimizing analysis.

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Comparative analysis of programmed death ligand 1 expression in paired cytologic and histologic specimens of non–small cell lung cancer

Cited by 9 publications

References 29 publications

Evaluation of programmed death ligand 1 expression in cytology to determine eligibility for immune checkpoint inhibitor therapy in patients with head and neck squamous cell carcinoma

Evaluation of programmed death ligand 1 expression in cytology to determine eligibility for immune checkpoint inhibitor therapy in patients with head and neck squamous cell carcinoma

PD-L1 in Cytological Samples: A Review and a Practical Approach

Program death ligand‐1 immunocytochemistry in lung cancer cytological samples: A systematic review

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