PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation.
Summers, Yvonne J
AffiliationDepartment of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry
MetadataShow full item record
AbstractA new approach to the management of non-small-cell lung cancer (NSCLC) has recently emerged that works by manipulating the immune checkpoint controlled by programmed death receptor 1 (PD-1) and its ligand programmed death ligand 1 (PD-L1). Several drugs have been approved or are in the late stages of development targeting PD-1 (pembrolizumab and nivolumab) or PD-L1 (atezolizumab, durvalumab and avelumab). Inevitably, the introduction of these drugs will place pressure on healthcare systems and there is a need to stratify patients to identify those who are most likely to benefit from such treatment. There is evidence that responsiveness to PD-1 inhibitors may be predicted by expression of PD-L1 on neoplastic cells. Hence, there is considerable interest in using PD-L1 immunohistochemical staining to guide the use of PD-1-targeted treatments in patients with NSCLC. This paper reviews the current knowledge about PD-L1 testing and identifies current research requirements. Key factors to consider include the source and timing of sample collection, pre-analytical steps (sample tracking, fixation, tissue processing, sectioning and tissue prioritization), analytical decisions (choice of biomarker assay/kit and automated staining platform, with verification of standardized assays or validation of laboratory-devised techniques, internal and external quality assurance and audit), and reporting and interpretation of the results. This review addresses the need for integration of PD-L1 immunohistochemistry with other tests as part of locally agreed pathways and protocols. There remain areas of uncertainty and guidance should be updated regularly as new information becomes available. This article is protected by copyright. All rights reserved.
CitationPD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation. 2016: Histopathology
- The Significance of the PD-L1 Expression in Non-Small-Cell Lung Cancer: Trenchant Double Swords as Predictive and Prognostic Markers.
- Authors: Takada K, Toyokawa G, Shoji F, Okamoto T, Maehara Y
- Issue date: 2018 Mar
- Development of a programmed cell death ligand-1 immunohistochemical assay validated for analysis of non-small cell lung cancer and head and neck squamous cell carcinoma.
- Authors: Rebelatto MC, Midha A, Mistry A, Sabalos C, Schechter N, Li X, Jin X, Steele KE, Robbins PB, Blake-Haskins JA, Walker J
- Issue date: 2016 Oct 8
- Comparison of PD-L1 immunohistochemistry assays and response to PD-1/L1 inhibitors in advanced non-small-cell lung cancer in clinical practice.
- Authors: Villaruz LC, Ancevski Hunter K, Kurland BF, Abberbock S, Herbst C, Dacic S
- Issue date: 2019 Jan
- Use of the 22C3 anti-programmed death-ligand 1 antibody to determine programmed death-ligand 1 expression in cytology samples obtained from non-small cell lung cancer patients.
- Authors: Ilie M, Juco J, Huang L, Hofman V, Khambata-Ford S, Hofman P
- Issue date: 2018 Apr
- Companion and Complementary Diagnostics-Focus on PD-L1 Expression Assays for PD-1/PD-L1 Checkpoint Inhibitors in Non-Small Cell Lung Cancer.
- Authors: Hersom M, Jørgensen JT
- Issue date: 2018 Feb