Lung carcinoma predictive biomarker testing by immunoperoxidase stains in cytology and small biopsy specimens: Advantages and limitations Journal Article


Authors: Zhou, F.; Moreira, A. L.
Article Title: Lung carcinoma predictive biomarker testing by immunoperoxidase stains in cytology and small biopsy specimens: Advantages and limitations
Abstract: Context. - In the burgeoning era of molecular genomics, immunoperoxidase (IPOX) testing grows increasingly relevant as an efficient and effective molecular screening tool. Patients with lung carcinoma may especially benefit from the use of IPOX because most lung carcinomas are inoperable at diagnosis and only diagnosed by small tissue biopsy or fine-needle sampling. When such small specimens are at times inadequate for molecular testing, positive IPOX results still provide actionable information. Objective. - To describe the benefits and pitfalls of IPOX in the detection of biomarkers in lung carcinoma cytology specimens and small biopsies by summarizing the currently available commercial antibodies, preanalytic variables, and analytic considerations. Data Sources. - PubMed. Conclusions. - Commercial antibodies exist for IPOX detection of aberrant protein expression due to EGFR L858R mutation, EGFR E746-A750 deletion, ALK rearrangement, ROS1 rearrangement, and BRAF V600E mutation, as well as PD-L1 expression in tumor cells. Automated IPOX protocols for ALK and PD-L1 detection were recently approved by the Food and Drug Administration as companion diagnostics for targeted therapies, but consistent interpretive criteria remain to be elucidated, and such protocols do not yet exist for other biomarkers. The inclusion of cytology specimens in clinical trials would expand patients' access to testing and treatment, yet there is a scarcity of clinical trial data regarding the application of IPOX to cytology, which can be attributed to trial designers' lack of familiarity with the advantages and limitations of cytology. The content of this review may be used to inform clinical trial design and advance IPOX validation studies. © 2016, College of American Pathologists. All rights reserved.
Journal Title: Archives of Pathology & Laboratory Medicine
Volume: 140
Issue: 12
ISSN: 0003-9985
Publisher: College of American Pathologists  
Date Published: 2016-12-01
Start Page: 1331
End Page: 1337
Language: English
DOI: 10.5858/arpa.2016-0157-RA
PROVIDER: scopus
PUBMED: 27588333
DOI/URL:
Notes: Review -- Export Date: 3 January 2017 -- Source: Scopus
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  1. Andre L Moreira
    176 Moreira
  2. Fang   Zhou
    1 Zhou