PD-L1 in NSCLC cytology

Kovacevic, M.; Kern, Izidor; Gabric, Simona

doi:10.1093/annonc/mdx090.004

Cited by 4 publications

(4 citation statements)

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“…Currently, all commercially available immunohistochemistry assays have been validated to be used with FFPE specimens (2)(3)(4). However, in routine clinical practice about 40-50% of NSCLC patients have only cytology samples available for diagnosis, staging, and biomarker analysis (5).…”

Section: Introductionmentioning

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%

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…A significant percentage of patients with non‐small cell lung cancer will only have cytology specimens available for diagnosis and immune checkpoint analysis. The frequent limitation of material to cytologic specimens complicates issues of PD‐L1 expression heterogeneity as well as optimal cytologic specimen type and fixation method 15,16 . Despite these challenges, cytologic specimens have been shown to be acceptable samples for PD‐L1 analysis 17–41 .…”

Section: Resultsmentioning

confidence: 99%

“…The frequent limitation of material to cytologic specimens complicates issues of PD-L1 expression heterogeneity as well as optimal cytologic specimen type and fixation method. 15,16 Despite these challenges, cytologic specimens have been shown to be acceptable samples for PD-L1 analysis. A number of issues impact the optimal type of specimen for PD-L1 analysis.…”

Section: Cytology Specimens In Pd-l1 Testingmentioning

confidence: 99%

PD‐L1 immunohistochemical testing: A review with reference to cytology specimens

Layfield

Zhang²,

Esebua

2022

Diagnostic Cytopathology

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Background: Immunotherapy based on disruption of the PD-1/PD-L1 axis is standard of care for many high stage malignancies including melanomas, non-small cell carcinomas of the lung, triple negative breast carcinomas, and squamous cell carcinomas of the head and neck. Eligibility for immunotherapy requires immunohistochemical assessment of PD-L1 expression. Currently, many high stage malignancies are diagnosed by cytology and cytologic material is the only specimen available for ancillary testing. Formal guidelines do not currently exist defining the optimal specimen type, antibody to be used or the best scoring system for cytologic material. Significant information has been published for PD-L1 testing of pulmonary specimens but much less data exists for the reproducibility, accuracy and best practices for material obtained from other body sites and types of malignancy. Methods:We searched the PubMed data base for manuscripts relating to PD-L1 testing of cytologic specimens. The search period was between 2016 and 2022. The search terms used were PD-L1, cytology, FNA, immunotherapy, immunohistochemistry, immunocytochemistry, cytology-histology correlation. Cross referencing techniques were used to screen for the most relevant manuscripts. The abstracts of these were then reviewed for final data collection and analysis.Results: A total of 86 studies were identified conforming to study relevancy. These were reviewed in their entirety by two authors (LJL, TZ) for extraction of data. The majority of studies involved pulmonary specimens (79) with three relating to PD-L1 testing of head and neck cytologic specimens and one each for PD-L1 testing of cytology specimens from melanomas, pancreas, pleural fluids, and triple negative breast carcinomas. While smears could be used, most studies found cell blocks optimal for testing.Summary: Currently, four drugs are approved for immunotherapy based on PD-L1 status. These drugs require specific antibody clones as well as scoring systems. Scoring systems and cut points vary with the type of neoplasm being treated. Cytology specimens from the lung, head and neck and melanomas can all be used for PD-L1 testing with good agreement with corresponding histology specimens.

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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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PD-L1 in NSCLC cytology

Cited by 4 publications

References 0 publications

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

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

PD‐L1 immunohistochemical testing: A review with reference to cytology specimens

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

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