Fabio Perrotta1, Matthew Nankivell2, Jana B Adizie3, Usman Maqsood4, Mohamed Elshafi5, Syeda Jafri6, Andrew D Lerner7, Ian Woolhouse3, Mohammed Munavvar4, Matthew Evison5, Richard Booton5, David R Baldwin6, Samuel M Janes8, Keith M Kerr9, Andrea Bianco10, Lonny Yarmus7, Neal Navani11. 1. Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy; Lungs for Living Research Centre, UCL Respiratory, University College London, London, England. Electronic address: fabio.perrotta@unimol.it. 2. MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, England. 3. University Hospitals Birmingham, Birmingham, England. 4. Lancashire Teaching Hospitals, Preston, England. 5. Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, England. 6. Nottingham University Hospitals, Nottingham, England. 7. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD. 8. Lungs for Living Research Centre, UCL Respiratory, University College London, London, England. 9. Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, Scotland. 10. Department of Translational Medicine, University of Campania "L. Vanvitelli," Naples, Italy. 11. Lungs for Living Research Centre, UCL Respiratory, University College London, London, England; Department of Thoracic Medicine, University College London Hospital, London, England.
Abstract
BACKGROUND: Programmed death-ligand 1 (PD-L1) expression on cancer cells is a clinically important biomarker to select patients with non-small cell lung cancer (NSCLC) for treatment with programmed death-1/PD-L1 inhibitors. Clinical trials of immunotherapy in patients with NSCLC have required histologic evidence for PD-L1 testing; in clinical practice, cytologic samples commonly are acquired in patients with advanced disease. RESEARCH QUESTION: This study aims to investigate whether endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples are adequate for PD-L1 testing in NSCLC. STUDY DESIGN AND METHODS: This study investigates the sampling adequacy of EBUS-TBNA for PD-L1 testing when compared with other methods. Furthermore, the relationship between clinicopathologic characteristics and PD-L1 expression in the study population have been examined. Five hundred seventy-seven NSCLC specimens were analyzed from consecutive patients with NSCLC across six centers in the United Kingdom and one center in the United States between January 2015 and December 2016. RESULTS: In the EBUS-TBNA group (189 specimens), the overall percentage of patients with successful PD-L1 testing was 94.7%. There was no significant difference in sampling adequacy with other methods of tissue acquisition. Older patients had higher failure rates of PD-L1 testing (OR, 1.06; P = .008). In multivariate analysis, advanced N-stage (P = .048) and presence of brain metastasis (P < .001) were associated with high PD-L1 expression. INTERPRETATION: This large multicenter study shows that EBUS-TBNA provides samples adequate for PD-L1 testing and that advanced N stage and the presence of brain metastasis are associated with high PD-L1 expression.
BACKGROUND: Programmed death-ligand 1 (PD-L1) expression on cancer cells is a clinically important biomarker to select patients with non-small cell lung cancer (NSCLC) for treatment with programmed death-1/PD-L1 inhibitors. Clinical trials of immunotherapy in patients with NSCLC have required histologic evidence for PD-L1 testing; in clinical practice, cytologic samples commonly are acquired in patients with advanced disease. RESEARCH QUESTION: This study aims to investigate whether endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples are adequate for PD-L1 testing in NSCLC. STUDY DESIGN AND METHODS: This study investigates the sampling adequacy of EBUS-TBNA for PD-L1 testing when compared with other methods. Furthermore, the relationship between clinicopathologic characteristics and PD-L1 expression in the study population have been examined. Five hundred seventy-seven NSCLC specimens were analyzed from consecutive patients with NSCLC across six centers in the United Kingdom and one center in the United States between January 2015 and December 2016. RESULTS: In the EBUS-TBNA group (189 specimens), the overall percentage of patients with successful PD-L1 testing was 94.7%. There was no significant difference in sampling adequacy with other methods of tissue acquisition. Older patients had higher failure rates of PD-L1 testing (OR, 1.06; P = .008). In multivariate analysis, advanced N-stage (P = .048) and presence of brain metastasis (P < .001) were associated with high PD-L1 expression. INTERPRETATION: This large multicenter study shows that EBUS-TBNA provides samples adequate for PD-L1 testing and that advanced N stage and the presence of brain metastasis are associated with high PD-L1 expression.
Authors: Ersilia Nigro; Fabio Perrotta; Filippo Scialò; Vito D'Agnano; Marta Mallardo; Andrea Bianco; Aurora Daniele Journal: Int J Environ Res Public Health Date: 2021-03-01 Impact factor: 3.390
Authors: Huzaifa A Jaliawala; Samid M Farooqui; Kassem Harris; Tony Abdo; Jean I Keddissi; Houssein A Youness Journal: Diagnostics (Basel) Date: 2021-12-10