Takahiro Ota1,2,3, Keisuke Kirita4, Reiko Matsuzawa5, Hibiki Udagawa1, Shingo Matsumoto1, Kiyotaka Yoh1, Seiji Niho1, Genichiro Ishii2,3, Koichi Goto1. 1. Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. 2. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan. 3. Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan. 4. Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. kkirita@ncc.go.jp. 5. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Abstract
PURPOSE: Histology samples are important for the appropriate administration of tumor type-specific cytotoxic and molecular-targeted therapies for the treatment of non-small cell lung cancer (NSCLC). When biopsy samples lack a definite morphology, a diagnosis can be selected from three subtypes based on immunohistochemistry (IHC) results, as follows: favor adenocarcinoma (ADC), favor squamous cell carcinoma (SQC), or not otherwise specified (NOS)-null. In terms of patient outcome, however, the validity of IHC-based classifications remains unknown. METHODS: A large series of 152 patients with advanced NSCLC whose diagnoses had been made based on morphological findings and who had been homogeneously treated were enrolled. We used IHC staining (TTF-1, SP-A, p40, and CK5/6) to examine tumor samples and refined the diagnoses. We then analyzed the pathological subgroups according to the IHC staining results. RESULTS: IHC profiling resulted in 50% of the cases being classified as favor ADC, 31% being classified as favor SQC, and 19% being classified as NOS-null groups. Compared with the favor ADC and favor SQC groups, the NOS-null group had a significantly poorer outcome. Pemetrexed-containing platinum regimens produced a response rate similar to that of other platinum doublet regimens in the favor ADC group (44% vs. 46%), whereas it produced a poorer response in the favor SQC group (0% vs. 52%) and the NOS-null group (0% vs. 24%). The favor ADC group tended to have a higher percentage of EGFR positivity and ALK positivity than the favor SQC group (25% vs. 11% and 7% vs. 0%, respectively). CONCLUSIONS: These findings support the use of immunohistological subtyping of NSCLC biopsy specimens to select patient-appropriate treatments.
PURPOSE: Histology samples are important for the appropriate administration of tumor type-specific cytotoxic and molecular-targeted therapies for the treatment of non-small cell lung cancer (NSCLC). When biopsy samples lack a definite morphology, a diagnosis can be selected from three subtypes based on immunohistochemistry (IHC) results, as follows: favor adenocarcinoma (ADC), favor squamous cell carcinoma (SQC), or not otherwise specified (NOS)-null. In terms of patient outcome, however, the validity of IHC-based classifications remains unknown. METHODS: A large series of 152 patients with advanced NSCLC whose diagnoses had been made based on morphological findings and who had been homogeneously treated were enrolled. We used IHC staining (TTF-1, SP-A, p40, and CK5/6) to examine tumor samples and refined the diagnoses. We then analyzed the pathological subgroups according to the IHC staining results. RESULTS: IHC profiling resulted in 50% of the cases being classified as favor ADC, 31% being classified as favor SQC, and 19% being classified as NOS-null groups. Compared with the favor ADC and favor SQC groups, the NOS-null group had a significantly poorer outcome. Pemetrexed-containing platinum regimens produced a response rate similar to that of other platinum doublet regimens in the favor ADC group (44% vs. 46%), whereas it produced a poorer response in the favor SQC group (0% vs. 52%) and the NOS-null group (0% vs. 24%). The favor ADC group tended to have a higher percentage of EGFR positivity and ALK positivity than the favor SQC group (25% vs. 11% and 7% vs. 0%, respectively). CONCLUSIONS: These findings support the use of immunohistological subtyping of NSCLC biopsy specimens to select patient-appropriate treatments.
Authors: Marta Salido; Lara Pijuan; Luz Martínez-Avilés; Ana B Galván; Israel Cañadas; Ana Rovira; Montserrat Zanui; Alejandro Martínez; Raquel Longarón; Francisco Sole; Sergio Serrano; Beatriz Bellosillo; Murry W Wynes; Joan Albanell; Fred R Hirsch; Edurne Arriola Journal: J Thorac Oncol Date: 2011-01 Impact factor: 15.609
Authors: Ramaswamy Govindan; Aleksandra Szczesna; Myung-Ju Ahn; Claus-Peter Schneider; Pablo Fernando Gonzalez Mella; Fabrice Barlesi; Baohui Han; Doina Elena Ganea; Joachim Von Pawel; Vladimir Vladimirov; Natalia Fadeeva; Ki Hyeong Lee; Takayasu Kurata; Li Zhang; Tomohide Tamura; Pieter E Postmus; Jacek Jassem; Kenneth O'Byrne; Justin Kopit; Mingshun Li; Marina Tschaika; Martin Reck Journal: J Clin Oncol Date: 2017-08-30 Impact factor: 44.544
Authors: Jyoti D Patel; Mark A Socinski; Edward B Garon; Craig H Reynolds; David R Spigel; Mark R Olsen; Robert C Hermann; Robert M Jotte; Thaddeus Beck; Donald A Richards; Susan C Guba; Jingyi Liu; Bente Frimodt-Moller; William J John; Coleman K Obasaju; Eduardo J Pennella; Philip Bonomi; Ramaswamy Govindan Journal: J Clin Oncol Date: 2013-10-21 Impact factor: 44.544
Authors: Natasha Rekhtman; Laura J Tafe; Jamie E Chaft; Lu Wang; Maria E Arcila; Agnes Colanta; Andre L Moreira; Maureen F Zakowski; William D Travis; Camelia S Sima; Mark G Kris; Marc Ladanyi Journal: Mod Pathol Date: 2012-11-30 Impact factor: 7.842