Interobserver agreement of PD-L1 (SP263) assessment in advanced NSCLC on cytological smears and histological samples.


Journal

Pathology, research and practice
ISSN: 1618-0631
Titre abrégé: Pathol Res Pract
Pays: Germany
ID NLM: 7806109

Informations de publication

Date de publication:
May 2022
Historique:
received: 04 03 2022
revised: 07 04 2022
accepted: 08 04 2022
pubmed: 17 4 2022
medline: 6 5 2022
entrez: 16 4 2022
Statut: ppublish

Résumé

The PD-L1 assessment is mandatory for the selection of patients affected by advanced non-small-cell lung cancer (NSCLC) who can benefit from the PD-1/PD-L1 checkpoint inhibitors therapy. Previous studies tested PD-L1 on cytological smears to evaluate this sample as an alternative to formalin-fixed paraffin-embedded (FFPE) ones, but several critical issues needed to be clarified. We evaluated the cyto-histological agreement (CHA) and the PD-L1 interobserver agreement (IrOA) among three different pathologists (Path1, Path2, Path3) on 160 paired cytological smears and histological samples of advanced NSCLC. With the cut-off of < 50%/≥ 50%, CHA resulted good for Path1 (Cohen's k: 0.702) and Path3 (Cohen's k: 0.731), moderate for Path2 (Cohen's k: 0.576) adopting the same cut-off, the IrOA was moderate (ICC 0.72 [95% CI: 0.63-0.78]) for smears and good for histological samples (ICC 0.85 [95% CI: 0.80-0.85]). With a cut-off system of < 50%/≥ 50%, PD-L1 assessment shows moderate to good CHA and exhibited moderate IrOA on smears and good IrOA on FFPE. As result, PD-L1 assessment should be improved on cytological smears as well as could be a suitable alternative for patients without FFPE samples and not eligible for pembrolizumab, adopting a cut-off of < 50%/≥ 50%; presumably, an appropriate pathologist training could further improve the reproducibility.

Sections du résumé

BACKGROUND BACKGROUND
The PD-L1 assessment is mandatory for the selection of patients affected by advanced non-small-cell lung cancer (NSCLC) who can benefit from the PD-1/PD-L1 checkpoint inhibitors therapy. Previous studies tested PD-L1 on cytological smears to evaluate this sample as an alternative to formalin-fixed paraffin-embedded (FFPE) ones, but several critical issues needed to be clarified.
AIM OBJECTIVE
We evaluated the cyto-histological agreement (CHA) and the PD-L1 interobserver agreement (IrOA) among three different pathologists (Path1, Path2, Path3) on 160 paired cytological smears and histological samples of advanced NSCLC.
RESULTS RESULTS
With the cut-off of < 50%/≥ 50%, CHA resulted good for Path1 (Cohen's k: 0.702) and Path3 (Cohen's k: 0.731), moderate for Path2 (Cohen's k: 0.576) adopting the same cut-off, the IrOA was moderate (ICC 0.72 [95% CI: 0.63-0.78]) for smears and good for histological samples (ICC 0.85 [95% CI: 0.80-0.85]).
CONCLUSION CONCLUSIONS
With a cut-off system of < 50%/≥ 50%, PD-L1 assessment shows moderate to good CHA and exhibited moderate IrOA on smears and good IrOA on FFPE. As result, PD-L1 assessment should be improved on cytological smears as well as could be a suitable alternative for patients without FFPE samples and not eligible for pembrolizumab, adopting a cut-off of < 50%/≥ 50%; presumably, an appropriate pathologist training could further improve the reproducibility.

Identifiants

pubmed: 35429890
pii: S0344-0338(22)00137-6
doi: 10.1016/j.prp.2022.153893
pii:
doi:

Substances chimiques

B7-H1 Antigen 0
CD274 protein, human 0
Immune Checkpoint Inhibitors 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

153893

Informations de copyright

Copyright © 2022 Elsevier GmbH. All rights reserved.

Auteurs

Francesca Ambrosi (F)

Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy.

Francesca Giunchi (F)

Pathology Unit, IRCCS Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy.

Elisa Capizzi (E)

Pathology Unit, IRCCS Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy.

Alessandra Cancellieri (A)

Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Rocco Trisolini (R)

Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Andrea Ardizzoni (A)

Department of Medical Oncology, IRCCS Policlinico Sant'Orsola-Malpighi, University of Bologna, Italy.

Michelangelo Fiorentino (M)

Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Pathology Unit, IRCCS Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy. Electronic address: michelangelo.fiorentino@unibo.it.

Costantino Ricci (C)

Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.

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Classifications MeSH