Concordance of PD-L1 expression in triple-negative breast cancers in Chinese patients: A retrospective and pathologist-based study

Chen, Chen; Ma, Xiaoxi; Li, Yanping; Ma, Jing; Yang, Wentao; Shui, Ruohong

doi:10.1016/j.prp.2022.154137

Cited by 2 publications

(1 citation statement)

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“…A prospective multi-institutional study showed the poor reproducibility of PD-L1 scoring, with pathologists disagreeing on the classification of cases as PD-L1-positive or -negative in over half of the scored cases, and the with complete agreement of SP-142 scoring in only 38% of cases [21]. In a cohort of 426 tumours of Chinese women, the concordance between two pathologists in PDL-1 scoring was 78.2%, with a Kappa value of 0.567, and 61.4% in primary tumours and nodal metastasis, respectively, indicating moderate agreement [22]. Using "Observers Needed to Evaluate Subjective Tests" (ONEST), Reisenbichler et al [21] reported a decreased overall percentage agreement with the increase in the number of pathologists assessing each case, with the lowest concordance at eight pathologists or more.…”

Section: Discussionmentioning

confidence: 92%

Inter- and Intra-Observer Agreement of PD-L1 SP142 Scoring in Breast Carcinoma—A Large Multi-Institutional International Study

Zaakouk

Bockstal

Galant

et al. 2023

Cancers

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The assessment of PD-L1 expression in TNBC is a prerequisite for selecting patients for immunotherapy. The accurate assessment of PD-L1 is pivotal, but the data suggest poor reproducibility. A total of 100 core biopsies were stained using the VENTANA Roche SP142 assay, scanned and scored by 12 pathologists. Absolute agreement, consensus scoring, Cohen’s Kappa and intraclass correlation coefficient (ICC) were assessed. A second scoring round after a washout period to assess intra-observer agreement was carried out. Absolute agreement occurred in 52% and 60% of cases in the first and second round, respectively. Overall agreement was substantial (Kappa 0.654–0.655) and higher for expert pathologists, particularly on scoring TNBC (6.00 vs. 0.568 in the second round). The intra-observer agreement was substantial to almost perfect (Kappa: 0.667–0.956), regardless of PD-L1 scoring experience. The expert scorers were more concordant in evaluating staining percentage compared with the non-experienced scorers (R2 = 0.920 vs. 0.890). Discordance predominantly occurred in low-expressing cases around the 1% value. Some technical reasons contributed to the discordance. The study shows reassuringly strong inter- and intra-observer concordance among pathologists in PD-L1 scoring. A proportion of low-expressors remain challenging to assess, and these would benefit from addressing the technical issues, testing a different sample and/or referring for expert opinions.

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Section: Discussionmentioning

confidence: 92%