PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation.
Authors
Cree, IBooton, R
Cane, P
Gosney, J
Ibrahim, M
Kerr, K
Lal, R
Lewanski, C
Navani, N
Nicholson, A
Nicolson, M
Summers, Yvonne J
Affiliation
Department of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, CoventryIssue Date
2016-05-19
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Show full item recordAbstract
A 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.Citation
PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation. 2016: HistopathologyJournal
HistopathologyDOI
10.1111/his.12996PubMed ID
27196116Type
ArticleLanguage
enISSN
1365-2559ae974a485f413a2113503eed53cd6c53
10.1111/his.12996
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