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Published on: July 31, 2017
Interobserver variation in CD30 immunohistochemistry interpretation; consequences for patient selection for targeted
Lianne Koens1, Peter M van de Ven2, Nathalie J Hijmering3
1Department of Pathology, Academic Medical Center, Amsterdam, the Netherlands.
CD30 immunohistochemistry (IHC) staining shows poor reproducibility among pathologists, impacting patient selection for brentuximab vedotin treatment in clinical trials and daily practice. Improving CD30 scoring consistency is crucial for accurate lymphoma diagnosis and therapy. Keywords: CD30 IHC, lymphoma, brentuximab vedotin, reproducibility, patient selection.
Area of Science:
- Oncology
- Pathology
- Clinical Trials
Background:
- CD30 immunohistochemistry (IHC) is vital for selecting patients for brentuximab vedotin therapy in malignant lymphoma.
- Reliable CD30 IHC staining is necessary for consistent patient selection in clinical trials and daily practice.
Purpose of the Study:
- To assess the technical variation and interobserver reproducibility of CD30 IHC staining in malignant lymphoma.
- To evaluate the impact of CD30 scoring on patient eligibility for brentuximab vedotin treatment.
Main Methods:
- A three-round reproducibility assessment of CD30 scoring (frequency and intensity) was conducted.
- Methods included technical validation, live polling, and a web-based scoring round mimicking daily practice.
- Agreement was measured using Kappa (κ) statistics.
Main Results:
- Poor to fair agreement was observed for CD30 tumor cell percentage (κ = 0.12-0.35) and staining intensity (κ = 0.16-0.41).
- Agreement improved slightly with one category of freedom for percentage (κ = 0.30-0.61) but remained suboptimal.
- Objective differences in staining intensity were noted between laboratories, and pathologists showed hesitancy in decision-making.
Conclusions:
- Lack of agreement in CD30 scoring, especially with heterogeneous expression, affects patient eligibility for brentuximab vedotin.
- Suboptimal reproducibility limits the predictive value of CD30 expression for clinical response.
- Standardization of CD30 IHC is needed for reliable patient selection and treatment efficacy.
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