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Philippe Taniere
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P2.09 - Pathology (Not CME Accredited Session) (ID 958)
- 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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P2.09-06 - Expression of PD-L1 on Routine Non-Small Cell Lung Carcinoma Sections: Comparative Assessment of SP263 (Ventana) and 22C3 (DAKO pharmDx) (ID 13019)
16:45 - 18:00 | Author(s): Philippe Taniere
- Abstract
Background
The SP263 (Ventana Benchmark) antibody as a predictive immunohistochemical marker for pembrolizumab therapy provides an avenue for local testing. Pathologists without access to the Dako Autostainer Link 48 platform (certified for the Dako 22C3 antibody) have been restricted to referrals at external departments, resulting in an increased turnaround time. Here we report the results of our local verification of SP263.
a9ded1e5ce5d75814730bb4caaf49419 Method
Specimens previously assessed for 22C3 PD-L1 expression at either Royal Liverpool Hospital or Queen Elizabeth Hospital Birmingham were selected from the archives of Wythenshawe Hospital. Cases with less than 100 viable residual tumour cells were excluded. The same tumour block was selected for staining with the Roche SP263 clone and specimens were assessed for tumour proportion score (TPS), immune cell proportion and staining intensity. Assays were reported as disagreeing if a differing TPS changed the therapeutic cut-off ranges.
4c3880bb027f159e801041b1021e88e8 Result
Expression levels of 22C3 and SP263 were compared across 100 cases (43 resections, 26 biopsies, 26 lymph node aspirates, 5 node excisions); 59 adenocarcinomas, 33 squamous carcinomas, 8 not otherwise specified (70 primary, 30 metastatic). The TPS ranges (<1%, 1 - 49%, > 50%) were in agreement for 78 samples. Of the 22 cases with differing ranges, 15 reflected a TPS of <10% and 7 had greater differences e.g. 10% versus 60%. Reasons for discrepancies included faint membranous staining on a few of the 22C3 sections (not apparent on SP263), scoring of carcinoma in situ, possible scoring of cells at a deeper block level, and variation in interpretation by the scoring pathologists. The overall Pearson correlation coefficient (r) was 0.9025, p < 0.00001.
Table 1 Comparison of PD-L1 Ventana SP263 and Dako 22C3 tumour proportion scores SAMPLE DIAGNOSIS SP263 >/= 1% >/= 50% Liverpool
22C3
Birmingham
22C3
Discrepancy Pleural biopsy
Adenocarcinoma
1
No
No
1
N/A
No
Pleural biopsy
Adenocarcinoma
10
No
No
60
N/A
Yes
EBUS node
Metastatic adenocarcinoma
0
No
No
0
N/A
No
EBUS node
Metastatic adenocarcinoma
0
No
No
1
N/A
Yes
Resection
Adenocarcinoma
40
Yes
No
10
N/A
No
EBUS node
Metastatic squamous carcinoma
2
No
No
10
N/A
No
Resection
Adenocarcinoma
5
Yes
No
<1
N/A
Yes
EBUS node
Metastatic adenocarcinoma
0
No
No
0
N/A
No
Bronchial biopsy
Squamous carcinoma
10
Yes
No
70
N/A
Yes
Bronchial biopsy
Squamous carcinoma
0
No
No
0
N/A
No
EBUS node
Metastatic squamous carcinoma
<1
No
No
<1
N/A
No
EBUS node
Metastatic adenocarcinoma
<1
No
No
0
N/A
No
Bronchial biopsy
Squamous carcinoma
40
Yes
No
40
N/A
No
Resection
Squamous carcinoma
5
Yes
No
10
N/A
No
Lung biopsy
Adenocarcinoma
0
No
No
0
N/A
No
Lymph node biopsy
Metastatic adenocarcinoma
100
Yes
Yes
100
N/A
No
Resection
Adenocarcinoma
<1
No
No
N/A
<1
No
Lung biopsy
Adenocarcinoma
0
No
No
N/A
0
No
Resection
Adenocarcinoma
0
No
No
0
N/A
No
Resection
Adenocarcinoma
10
Yes
No
N/A
5 to 10
No
Resection
Adenocarcinoma
20
Yes
Yes
N/A
20-30
No
Resection
Squamous carcinoma
2 to 4
Yes
No
N/A
3 to 5
No
Bronchial biopsy
Squamous carcinoma
<1
No
No
N/A
<1
No
Bronchial biopsy
Squamous carcinoma
2 to 4
Yes
No
1
N/A
No
Lymph node biopsy
Metastatic adenocarcinoma
100
Yes
Yes
100
N/A
No
Bronchial biopsy
NOS
<1
No
No
N/A
<1
No
Bronchial biopsy
Adenocarcinoma
0
No
No
1
N/A
Yes
Resection
Adenocarcinoma
2 to 4
Yes
No
10
N/A
No
Lymph node biopsy
Metastatic squamous carcinoma
80
Yes
Yes
70
N/A
No
EBUS node
Metastatic adenocarcinoma
80
Yes
Yes
80
N/A
No
Bronchial biopsy
Squamous carcinoma
0
No
No
N/A
<1
No
EBUS node
Metastatic adenocarcinoma
90
Yes
Yes
80
N/A
No
Pleural biopsy
Adenocarcinoma
0
No
No
10
N/A
Yes
Bronchial biopsy
Squamous carcinoma
0
No
No
0
N/A
No
Bronchial biopsy
Squamous carcinoma
5
Yes
No
N/A
0
Yes
EBUS node
Metastatic squamous carcinoma
50
Yes
Yes
50
N/A
No
Bronchial biopsy
Squamous carcinoma
2 to 4
Yes
No
10
N/A
No
EBUS node
Metastatic adenocarcinoma
70
Yes
Yes
N/A
70
No
EBUS node
Metastatic adenocarcinoma
100
Yes
Yes
100
N/A
No
Bronchial biopsy
Squamous carcinoma
1
Yes
No
20
N/A
No
Resection
Adenocarcinoma
5
Yes
No
0
N/A
Yes
Resection
Adenocarcinoma
0
No
No
0
N/A
No
EBUS node
Adenocarcinoma
<1
No
No
0
N/A
No
Resection
Adenocarcinoma
5
Yes
No
10
N/A
No
EBUS node
Sarcomatoid carcinoma
0
No
No
0
N/A
No
Resection
Adenocarcinoma
0
No
No
N/A
<1
No
Lymph node biopsy
Metastatic squamous carcinoma
0
No
No
N/A
<1
No
Resection
Adenocarcinoma
60
Yes
Yes
N/A
60-70
No
Bronchial biopsy
Squamous carcinoma
0
No
No
0
N/A
No
Pleural biopsy
Adenocarcinoma
2 to 4
Yes
No
10
N/A
No
Lung biopsy
Squamous carcinoma
0
No
No
5
N/A
Yes
EBUS node
Metastatic adenocarcinoma
5
Yes
No
30
N/A
No
Resection
Pleomorphic carcinoma
70
Yes
Yes
80
N/A
No
Resection
Squamous carcinoma
0
No
No
1
N/A
Yes
Bronchial biopsy
Squamous carcinoma
10
Yes
No
20
N/A
No
Resection
Adenocarcinoma
50
Yes
Yes
N/A
10 to 20
Yes
Resection
Adenocarcinoma
0
No
No
N/A
<1
No
Resection
Pleomorphic carcinoma
1
Yes
No
20
N/A
No
Resection
Adenocarcinoma
0
No
No
0
N/A
No
Resection
Adenocarcinoma
10
Yes
No
N/A
2 to 3
No
EBUS node
Metastatic adenocarcinoma
100
Yes
Yes
100
N/A
No
Resection
Adenocarcinoma
5
Yes
No
N/A
<1
Yes
EBUS node
Metastatic adenocarcinoma
100
Yes
Yes
100
N/A
No
EBUS node
Metastatic squamous carcinoma
50
Yes
Yes
N/A
80
No
Resection
Adenocarcinoma
90
Yes
Yes
95
N/A
No
Resection
Adenocarcinoma
<1
No
No
N/A
<1
No
Resection
Adenocarcinoma
0
No
No
1
0
Yes
Resection
Adenocarcinoma
<1
No
No
5
N/A
Yes
Resection
Adenocarcinoma
20
Yes
No
20
N/A
No
Bronchial biopsy
NOS
50
Yes
Yes
60
N/A
No
Resection
Adenocarcinoma
2 to 4
Yes
No
N/A
5 to 10
No
Resection
Adenocarcinoma
0
No
No
10
N/A
Yes
Soft tissue
NOS
1
Yes
No
20
N/A
No
Bronchial biopsy
Sarcomatoid carcinoma
<1
No
No
N/A
<1
No
EBUS node
Metastatic adenocarcinoma
70
Yes
Yes
N/A
60 to 70
No
Pleural biopsy
Adenocarcinoma
80
Yes
Yes
N/A
70
No
Resection
Squamous carcinoma
<1
No
No
1
0
Yes
Resection
Adenocarcinoma
50
Yes
Yes
N/A
5 to 10
Yes
Resection
Adenocarcinoma
10
Yes
No
50
N/A
Yes
Resection
Adenocarcinoma
0
No
No
0
N/A
No
Resection
Squamous carcinoma
1
Yes
No
N/A
<1
Yes
Resection
Squamous carcinoma
100
Yes
Yes
100
N/A
No
Resection
Squamous carcinoma
5
Yes
No
10
No
Resection
Squamous carcinoma
70
Yes
Yes
N/A
70 to 80
No
Resection
Squamous carcinoma
90
Yes
Yes
N/A
10 to 20
Yes
EBUS node
Squamous carcinoma
<1
No
No
N/A
<1
No
EBUS node
Adenocarcinoma
0
No
No
N/A
0
No
EBUS node
Metastatic adenocarcinoma
70
Yes
Yes
N/A
80
No
EBUS node
Metastatic squamous carcinoma
50
Yes
No
N/A
70
No
Resection
Adenocarcinoma
<1
No
No
N/A
<1
No
EBUS node
Metastatic adenocarcinoma
40
Yes
No
30
N/A
No
Resection
Squamous carcinoma
90
Yes
Yes
N/A
100
No
Resection
Adenocarcinoma
40
Yes
No
40
N/A
No
EBUS node
Metastatic adenocarcinoma
80
Yes
Yes
N/A
70 to 80
No
EBUS node
Metastatic squamous carcinoma
1
Yes
No
N/A
<1
Yes
Bronchial biopsy
Squamous carcinoma
1
Yes
No
1
N/A
No
EBUS node
Metastatic adenocarcinoma
5
Yes
No
60
N/A
Yes
Primary EBUS
Pleomorphic carcinoma
100
Yes
Yes
90
N/A
No
Resection
Adenocarcinoma
90
Yes
Yes
90
N/A
No
Lymph node biopsy
Adenocarcinoma
<1
No
No
<1
N/A
No
Tumour expression profiles of PD-L1 are similar for the 22C3 and SP263 antibodies, with a rate of variation similar to previous reports. Cases that are discrepant may reflect differences in pathologist interpretation rather than the assay.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.01-22 - An Exploratory Analysis of PD-L1 Expression and Smoking History in a Cohort of Advanced Non-Small Cell Lung Cancer Patients (ID 14052)
12:00 - 13:30 | Author(s): Philippe Taniere
- Abstract
Background
Response to PD-1 checkpoint inhibitors in NSCLC is associated with PD-L1 expression. One hypothesis is that high PD-L1 expression may correlate with tumour mutational load, the latter reflecting past tobacco exposure.
a9ded1e5ce5d75814730bb4caaf49419 Method
We examined PD-L1 expression by tumour proportion score (TPS) in patients with advanced NSCLC and correlated this with the subjects’ smoking history. Number of pack-years was estimated by the same individual during the initial consultation. Demographic characteristics, performance status(PS), stage, histology were obtained from the electronic patient records. PD-L1 testing was performed using the Dako PD-L1 IHC 22C3 pharmDx test in all but 3 cases where the SP263 Roche antibody was used. We compared pack-years and smoking status of subjects with PD-L1 negative(TPS<1%), weakly-positive (TPS1-49%) and strongly positive (TPS≥50%) NSCLC.
4c3880bb027f159e801041b1021e88e8 Result
Between 12/2016-3/2018, 54 biopsy specimens from 52 patients with advanced NSCLC were tested for PD-L1 expression at UHB. In 5 biopsies, material was not tested, as unsuitable in 4(<100 tumour cells present) and testing was cancelled in 1 patient who declined treatment. For the remaining 47 biopsies patient characteristics were: Median age 70 (43-82), male/female 26/21, PS 0/1/2/3-4 was 10/26/8/3, stage IIIA/IIIB/IV 3/18/26, histology adenoca/squamous/mixed 33/11/3. Median pack-years in PD-L1 negative 30(0-60), PD-L1 weakly positive 35(0-80), PD-L1 strongly positive 33(0-100); current+former smoker/never smoker numbers: PD-L1 negative 14/3(82.4%/17.6%), PD-L1 weakly positive 11/1(91.7%/8.3%), PD-L1 strongly positive 15/3(83.3%/16.7%). Strong/weak PD-L1 expression was seen in 3/1 never smokers; of these 2 had EGFR mutation. Weak expression was also seen in 1 ALK-positive NSCLC patient, former light smoker (5pack-years).
In this small retrospective cohort there were no differences in median pack-years of smoking or proportions of current+former/never smokers between PD-L1 negative and positive tumours. Smoking history alone may not be the only factor influencing PD-L1 expression. Never smoking status and EGFR-mutated/ALK-positive NSCLC should not be excluded from PD-L1 testing.
6f8b794f3246b0c1e1780bb4d4d5dc53