Rediscovering immunohistochemistry in lung cancer

Anna La Salvia ¹, May-Lucie Meyer ², Fred R Hirsch ²

⁰National Center for Drug Research and Evaluation, National Institute of Health (ISS), Rome 00161, Italy.

Critical Reviews in Oncology/hematology +

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May 30, 2024

View abstract on PubMed

Summary

Immunohistochemistry (IHC) remains crucial for non-small-cell lung cancer (NSCLC) diagnosis and targeted therapy selection, complementing genomic methods like next-generation sequencing (NGS) for optimal patient treatment.

Area Of Science

Oncology
Pathology
Molecular Diagnostics

Background

Next-generation sequencing (NGS) has shifted focus from protein expression analysis in non-small-cell lung cancer (NSCLC).
Immunohistochemistry (IHC) plays a vital role in assessing biomarkers for targeted therapy and immunotherapy in NSCLC patients.
The clinical utility of IHC in NSCLC diagnostics and treatment selection is often overlooked.

Purpose Of The Study

To re-evaluate the significance of immunohistochemistry (IHC) in non-small-cell lung cancer (NSCLC) diagnostics.
To emphasize the complementary role of IHC alongside genomic assays like NGS.
To advocate for the reconsideration of IHC in clinical practice for NSCLC patient management.

Main Methods

Review of current clinical practices and literature regarding biomarker testing in NSCLC.
Discussion on the protein-level analysis capabilities of IHC versus genomic methods.
Argument for integrating IHC into a comprehensive diagnostic panel for NSCLC.

Main Results

Protein expression analysis via IHC is essential for targeted therapy selection in NSCLC.
IHC is critical for identifying sensitivity to therapies in both oncogene-addicted and non-addicted NSCLC cases.
IHC serves as a valuable complement to NGS and other genomic assays for patient stratification.

Conclusions

IHC testing should be reconsidered and integrated into clinical practice for NSCLC.
A panel of IHC tests can enhance patient selection for innovative therapies.
Rigorous validation of IHC assays, scoring, and reproducibility is necessary for reliable clinical application.

Keywords:

Diagnostic value Immunohistochemistry Lung cancer Targeted therapies