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Tissue Selection for PD-L1 Testing in Triple Negative Breast Cancer (TNBC).

Florin Dobritoiu1,2, Adelina Baltan1, Alina Chefani1

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Applied Immunohistochemistry & Molecular Morphology : AIMM
|August 29, 2022
PubMed
Summary
This summary is machine-generated.

Tissue selection impacts PD-L1 testing for triple-negative breast cancer (TNBC). Excision samples are more reliable than core biopsies for PD-L1 assessment, guiding treatment decisions for atezolizumab therapy.

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Area of Science:

  • Oncology
  • Pathology
  • Immunotherapy

Background:

  • Atezolizumab plus nab-paclitaxel is approved for advanced triple-negative breast cancer (TNBC).
  • Patient selection for this therapy depends on PD-L1 testing using the SP142 antibody.
  • Optimal tissue selection for PD-L1 testing in TNBC remains unstandardized, potentially affecting treatment decisions.

Purpose of the Study:

  • To compare PD-L1 SP142 assessment between core biopsies and excision samples in TNBC.
  • To develop and implement a standardized workflow for PD-L1 testing in TNBC.
  • To provide an online resource aiding pathologists in PD-L1 scoring.

Main Methods:

  • Comparison of PD-L1 SP142 immunohistochemistry results from 73 matched TNBC core biopsies and excision samples.
  • Development and implementation of a clinical workflow for PD-L1 testing in a central laboratory.
  • Creation of an online atlas with numerical annotations for PD-L1 scoring interpretation.

Main Results:

  • Good correlation was observed between PD-L1 positive core biopsies and matched excisions.
  • Significant discrepancies were found between PD-L1 negative core biopsies and matched excisions, with 33% converting to positive in excision samples.
  • Audit data over two years demonstrated that the implemented workflow achieved PD-L1 positivity rates comparable to the IMpassion130 trial.

Conclusions:

  • Tissue selection significantly influences PD-L1 SP142 test results in TNBC.
  • A standardized workflow and an educational atlas can improve the reliability and consistency of PD-L1 testing for TNBC patients.
  • Accurate PD-L1 assessment is crucial for optimizing patient selection for atezolizumab treatment.