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T. Murakawa



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    MA 05 - Immuno-Oncology: Novel Biomarker Candidates (ID 658)

    • Event: WCLC 2017
    • Type: Mini Oral
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      MA 05.06 - Comparison Study of PD-L1 Immunohistochemistry Assays with 22C3 and 28-8: Analysis on Surgical Specimens of NSCLC. (ID 8423)

      15:45 - 17:30  |  Author(s): T. Murakawa

      • Abstract
      • Presentation
      • Slides

      Background:
      The checkpoint inhibitors programmed cell death and its ligand (PD-L1) antibodies are promising treatment agents for patients with advanced non-small cell lung cancer (NSCLC). Their clinical efficacy is predicted by drug-tailored PD-L1 immunohistochemistry (IHC) assays. We aimed to identify the similarity and distinction of 22C3 and 28-8 IHC tests.

      Method:
      Three hundred and ninety consecutive cases of completely resected NSCLC between January 2009 and September 2014 that had adequate tissue samples were investigated. From the archived samples, 5-μm thick sections were cut and stained with PD-L1 IHC 22C3 PharmDx and 28-8 PharmDx (Dako, Santa Clara, CA). The staining and evaluation in 22C3 and 28-8 test were performed by two separate laboratories. PD-L1 expression and high PD-L1 expression were defined as ≥1% and ≥50% of tumor cells stained, respectively. Statistical significance was defined as a p-value of <0.05.

      Result:
      The study population included 288 patients with adenocarcinomas, 70 with squamous cell carcinomas, 18 with large cell carcinomas, 9 with adenosquamous carcinoma and 5 with pleomorphic carcinoma. Two hundred and ninety-three patients had pStage I; 47, pStage II; and 46, p Stage IIIA tumors. Two hundred and twenty-nine specimens showed no PD-L1 expression with either 22C3 or 28-8. The detection rate of PD-L1 expression was 36.9% (144 cases) with 22C3 and 35.6% (139 cases) with 28-8, respectively (p= 0.710). The detection rate of high PD-L1 expression was 16.9% (66 cases) with 22C3 and 9.0% (35 cases) with 28-8 (p= 0.0013). The Spearman correlation coefficient was 0.866 (95% confidence interval, 0.838–0.890; p< 0.0001). Figure 1



      Conclusion:
      22C3 IHC assay may be more sensitive to detect high PD-L1 expression in NSCLC compard to 28-8 IHC assay, whereas 22C3 and 28-8 showed no significant difference to detect PD-L1 expression. Further investigation is necessary to reveal clinical, pathological and molecular background. This approach will help better interpretation of PD-L1 IHC results.

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    P2.16 - Surgery (ID 717)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P2.16-005 - Is There Any Oncological Concern about Preoperative Biopsy for Resectable Lung Cancer Patients? (ID 8708)

      09:30 - 16:00  |  Author(s): T. Murakawa

      • Abstract
      • Slides

      Background:
      Preoperative trans-bronchial biopsy and/or computed tomography (CT)–guided biopsy inevitably disrupt lung structure and might disseminate tumour cells into airway, vessels or the pleural cavity. Because preoperative diagnostic intervention may potentially disperse tumour cells, it may affect relapse and/or prognosis.

      Method:
      The data from the consecutive patients with cTanyN0M0 lung cancer who underwent surgery between January 2006 and December 2012 at our institute were extracted by chart review and analysed retrospectively. Prognostic factors of overall and recurrence-free survival were compared among the groups (the trans-bronchial biopsy group, the CT-guided biopsy group and the intra- or postoperative-diagnosis group) by using the univariate and multivariate Cox proportional hazard model. A stepwise backward elimination method with a probability level of 0.15 was used to select the most powerful sets of outcome predictors. A p-value <0.05 was considered statistically significant.

      Result:
      Data from 397 patients were available for analysis (the trans-bronchial biopsy group: 221, the CT-guided biopsy group: 71 and the intra- or postoperative-diagnosis group: 105). Solid tumour size was larger in the trans-bronchial biopsy and/or the CT–guided biopsy than the intra- or postoperative-diagnosis group (p = 0.0001). In the crude analysis, the trans-bronchial biopsy group and the CT-guided biopsy group showed higher probability of pleural dissemination (p = 0.048) and showed worse prognosis than the intra- or postoperative-diagnosis group (overall survival: p = 0.0458, recurrence-free survival: p = 0.0101). However, the method of diagnosis was not identified as an independent risk factor for pleural dissemination and overall and recurrence-free survivals by multivariate analyses. Figure 1



      Conclusion:
      Preoperative diagnostic intervention did not affect relapse and/or prognosis in this study cohort. Preoperative diagnostic intervention is recommended if necessary.

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