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Yasushi Yatabe
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ES08 - The Pathologist - An Essential Member of the Patient Care Team (ID 776)
- Event: WCLC 2018
- Type: Educational Session
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 13:30 - 15:00, Room 206 AC
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ES08.01 - Targeted Therapy (ID 11383)
13:30 - 13:50 | Presenting Author(s): Yasushi Yatabe
- Abstract
Abstract not provided
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OA03 - Advances in Lung Cancer Pathology (ID 897)
- Event: WCLC 2018
- Type: Oral Abstract Session
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 10:30 - 12:00, Room 205 BD
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OA03.03 - Phase 2B of Blueprint PD-L1 Immunohistochemistry Assay Comparability Study (ID 14530)
10:50 - 11:00 | Author(s): Yasushi Yatabe
- Abstract
- Presentation
Background
PD-L1 immunohistochemistry (IHC) has been established as companion or complementary diagnostic assays, each developed as predictive biomarker for specific anti PD1/PD-L1 immunotherapies. The Blueprint (BP) phase 1 comparability study demonstrated that three PD-L1 assays (28-8, 22C3, SP263) showed comparable analytical performance for assessment of PD-L1 expression on tumor cells (TPS), while the SP-142 PD-L1 assay appeared to stain a lower percentage of tumor cells when compared to the other assays. The first part of BP phase 2 (BP2A) re-affirmed these findings in a larger cohort of ‘real life’ specimens scored by 24 experienced pulmonary pathologists, and also showed that the 73-10 assay developed for avelumab showed greater sensitivity than all other assays to detect PD-L1 on tumour cells. BP2A also demonstrated generally excellent inter-observer agreement for tumor cell PD-L1 scoring using both glass slides and digital images, with slightly lesser agreement for the cytology samples included in the study cohort. Inter-observer agreement for immune cell scoring on glass or digital slides was poor. Phase 2B of Blueprint (BP2B) aimed to compare PD-L1 scoring on triplet samples representing large tumor resection blocks, small biopsy samples and fine needle aspirate cell blocks prepared from the same tumor. a9ded1e5ce5d75814730bb4caaf49419 Method
Triplet samples of large resected tumor block, small biopsy sample and fine needle aspirate cell block (the latter two taken from the resected tumour specimen) were gathered from 31 resected primary lung cancers (17 adenocarcinomas, 12 squamous cell carcinomas, and 2 large cell carcinomas). Sections from all 93 blocks were stained with the pharmDx 28-8 and 22C3, the FDA-approved SP142 and SP263, or clinical trial associated 73-10 PD-L1 assays, in a CLIA-approved immunohistochemistry laboratory. All H&E and PD-L1 IHC slides were scanned and digital images were used to score all cases by the same 24 pathologists involved in BP2A. As before, tumor cells PD-L1 staining were scored as continuous variable and into 7 cut-off-defined categories, as used in various immune checkpoint inhibitor trials. Immune cells were not scored. 4c3880bb027f159e801041b1021e88e8 Result
The data reaffirm the relative comparability of 28-8, 22C3 and SP263 assays across the range of scores; SP142 assay scores were lower, those for 73-10 higher. Inter-observer agreement between readers ranged from moderate to near perfect (Kappa-Fleiss (K-F) scores generally >0.7); best overall agreement was on aspirates. Overall, the agreement between scores on the different sample types from the same tumor was good (most K-F scores >0.7); aspirates showed no significant difference from biopsy samples or whole surgical blocks. In contrast to biopsies and surgical blocks, scores could, however, not be rendered in about 14% of aspirate sections. 8eea62084ca7e541d918e823422bd82e Conclusion
The results of BP2B confirms earlier results and also demonstrate comparable performance for fine needle aspirates in those cases where TPS scores were possible. 6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.16-34 - Visceral Pleural Invasion is Closely Associated with Nodal Spread in cStage IA Lung Adenocarcinoma (ID 12880)
16:45 - 18:00 | Author(s): Yasushi Yatabe
- Abstract
Background
Survival outcomes of patients with clinical Stage IA (cIA) lung adenocarcinoma (LAD) are favorable after resections. In this decade, limited resection without lymphnodes dissections have been indicated for selected cases based on the radiological findings and intraoperative hilar explorations, while we sometimes experience occult lymphnodes metastases among them. These facts refer that limited resections could potentially induce underestimation of the disease, local failure and worsened patients’ prognoses. In the present study, we retrospectively investigate the clinicopathological and oncogenic factors in association with the occult nodal spread and skip metastases, and aim to identify population for standard resection in cIA LAD.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively investigated 287 patients with cIA LAD who underwent standard pulmonary resections with mediastinal dissections from January 2013 through December 2017. Clinicopathological factors including location of the tumor, radiological pleural invasion and oncogenic status (EGFR/KRAS/ALK/Triple Negative) were reviewed for outcomes of occult nodal spread and skip metastasis. According to the ROC curves analyses, cutoff values of total diameter (TD), solid diameter (SD), mediastinal window diameter (MD) in CT image and pathological invasive size (IS) were settled to diagnose nodal metastases and skip pN2, respectively.
4c3880bb027f159e801041b1021e88e8 Result
Among 287 patients with cIA LAD, 34 (11.8%) with lymph node metastases and 8 (2.8%) with pN2 without hilar metastases (skip pN2) were identified. Univariate analyses revealed that high serum CEA level, TD, MD, SUVmax, IS and pathological pleural invasion (pl) were predictive for nodal metastases. And multivariate analysis showed that pl was closely associated with nodal metastases (Odds Ratio: 3.3, p=0.007). Furthermore, multivariate analysis following the univariate analyses also showed that presence of pl was the factor closely associated with skip N2 metastases (Odds Ratio: 5.7, p=0.029), whereas radiological findings nor oncogenic status were not so. In the clinical valuables, serum CEA level, SD, MD, SUVmax were significantly associated with pl.
8eea62084ca7e541d918e823422bd82e Conclusion
In resected cIA LAD, pathological pleural invasion was closely associated with both occult nodal spread and skip pN2, while any other preoperative factors and oncogenic status were not. New diagnostic modalities for pl may provide the candidates for standard resections in cIA LAD.
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