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Development of a 68Gallium-Labeled D-Peptide PET Tracer for Imaging Programmed Death-Ligand 1 Expression
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Programmed Cell Death Ligand 1 Immunohistochemistry: A Concordance Study Between Surgical Specimen, Biopsy, and
Hedvig Elfving1, Johanna Sofia Margareta Mattsson1, Cecilia Lindskog1
1Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Clinical Lung Cancer
|March 31, 2019
Summary
Programmed cell death ligand 1 (PD-L1) expression analysis on non-small-cell lung cancer biopsies shows moderate agreement with resection specimens. This suggests potential misclassification, particularly at lower thresholds, impacting treatment decisions.
Area of Science:
- Oncology
- Immunohistochemistry
- Cancer Diagnostics
Background:
- Programmed cell death ligand 1 (PD-L1) expression analysis is crucial for diagnosing non-small-cell lung cancer (NSCLC).
- Current diagnostic workup often relies on small biopsy samples, which may not fully represent the entire tumor.
- Evaluating PD-L1 expression in biopsies against resection specimens is essential for diagnostic accuracy.
Purpose of the Study:
- To assess the correlation between PD-L1 expression in non-small-cell lung cancer (NSCLC) biopsy specimens and their corresponding resection specimens.
- To determine the reliability of using small biopsy samples for PD-L1 analysis in NSCLC.
Main Methods:
- Compared PD-L1 expression using immunohistochemistry (SP263 antibody) on biopsy samples, whole-section resection specimens, and tissue microarrays (TMAs).
- Analyzed 58 NSCLC cases with both preoperative biopsy and resection specimens.
- Evaluated concordance using 1% and 50% PD-L1 expression cutoffs.
Main Results:
- PD-L1 expression proportions were comparable across biopsies, TMAs, and resection specimens (e.g., 43% vs. 48% at 1% cutoff).
- Biopsy analysis demonstrated good sensitivity (79%-82%) and specificity (90%-98%) compared to resection specimens.
- Moderate agreement (Cohen's κ 0.70-0.83) was observed, with higher concordance at the 50% cutoff.
Conclusions:
- A moderate concordance exists between PD-L1 analysis on NSCLC biopsies and resection specimens.
- Potential for sample misclassification, especially at the lower 1% PD-L1 expression cutoff, requires clinical awareness.
- Clinicians must consider this uncertainty when interpreting PD-L1 results for NSCLC treatment decisions.
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