PD-L1 testing for lung cancer in 2019: Perspective from the IASLC pathology committee Review


Authors: Lantuejoul, S.; Sound-Tsao, M.; Cooper, W. A.; Girard, N.; Hirsch, F. R.; Roden, A. C.; Lopez-Rios, F.; Jain, D.; Chou, T. Y.; Motoi, N.; Kerr, K. M.; Yatabe, Y.; Brambilla, E.; Longshore, J.; Papotti, M.; Sholl, L. M.; Thunnissen, E.; Rekhtman, N.; Borczuk, A.; Bubendorf, L.; Minami, Y.; Beasley, M. B.; Botling, J.; Chen, G.; Chung, J. H.; Dacic, S.; Hwang, D.; Lin, D.; Moreira, A.; Nicholson, A. G.; Noguchi, M.; Pelosi, G.; Poleri, C.; Travis, W.; Yoshida, A.; Daigneault, J. B.; Wistuba, I. I.; Mino-Kenudson, M.
Review Title: PD-L1 testing for lung cancer in 2019: Perspective from the IASLC pathology committee
Abstract: The recent development of immune checkpoint inhibitors (ICIs) has led to promising advances in the treatment of patients with NSCLC and SCLC with advanced or metastatic disease. Most ICIs target programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) axis with the aim of restoring antitumor immunity. Multiple clinical trials for ICIs have evaluated a predictive value of PD-L1 protein expression in tumor cells and tumor-infiltrating immune cells (ICs) by immunohistochemistry (IHC), for which different assays with specific IHC platforms were applied. Of those, some PD-L1 IHC assays have been validated for the prescription of the corresponding agent for first- or second-line treatment. However, not all laboratories are equipped with the dedicated platforms, and many laboratories have set up in-house or laboratory-developed tests that are more affordable than the generally expensive clinical trial–validated assays. Although PD-L1 IHC test is now deployed in most pathology laboratories, its appropriate implementation and interpretation are critical as a predictive biomarker and can be challenging owing to the multiple antibody clones and platforms or assays available and given the typically small size of samples provided. Because many articles have been published since the issue of the IASLC Atlas of PD-L1 Immunohistochemistry Testing in Lung Cancer, this review by the IASLC Pathology Committee provides updates on the indications of ICIs for lung cancer in 2019 and discusses important considerations on preanalytical, analytical, and postanalytical aspects of PD-L1 IHC testing, including specimen type, validation of assays, external quality assurance, and training. © 2019 International Association for the Study of Lung Cancer
Keywords: immunohistochemistry; protein expression; primary tumor; histopathology; review; cancer localization; advanced cancer; treatment indication; lung cancer; food and drug administration; validation study; tumor marker; prediction; distant metastasis; lung metastasis; immunotherapy; bioassay; tumor cell; intermethod comparison; immunocompetent cell; chemoradiotherapy; small cell lung cancer; programmed death 1 ligand 1; non small cell lung cancer; nsclc; pd-l1; sclc; cancer prognosis; human; priority journal; pembrolizumab; durvalumab; atezolizumab; 22c3 assay; 28 8 assay; sp142 assay; sp263 assay
Journal Title: Journal of Thoracic Oncology
Volume: 15
Issue: 4
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2020-04-01
Start Page: 499
End Page: 519
Language: English
DOI: 10.1016/j.jtho.2019.12.107
PUBMED: 31870882
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 1 April 2020 -- Source: Scopus
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  1. Natasha Rekhtman
    434 Rekhtman
  2. William D Travis
    750 Travis