Cree, IA;
Booton, R;
Cane, P;
Gosney, J;
Ibrahim, M;
Kerr, K;
Lal, R;
... Summers, Y; + view all
(2016)
PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation.
Histopathology
, 69
(2)
pp. 177-186.
10.1111/his.12996.
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Abstract
A new approach to the management of non-small-cell lung cancer (NSCLC) has recently emerged that works by manipulating the immune checkpoint controlled by programmed death receptor 1 (PD-1) and its ligand programmed death ligand 1 (PD-L1). Several drugs targeting PD-1 (pembrolizumab and nivolumab) or PD-L1 (atezolizumab, durvalumab, and avelumab) have been approved or are in the late stages of development. Inevitably, the introduction of these drugs will put pressure on healthcare systems, and there is a need to stratify patients to identify those who are most likely to benefit from such treatment. There is evidence that responsiveness to PD-1 inhibitors may be predicted by expression of PD-L1 on neoplastic cells. Hence, there is considerable interest in using PD-L1 immunohistochemical staining to guide the use of PD-1-targeted treatments in patients with NSCLC. This article reviews the current knowledge about PD-L1 testing, and identifies current research requirements. Key factors to consider include the source and timing of sample collection, pre-analytical steps (sample tracking, fixation, tissue processing, sectioning, and tissue prioritization), analytical decisions (choice of biomarker assay/kit and automated staining platform, with verification of standardized assays or validation of laboratory-devised techniques, internal and external quality assurance, and audit), and reporting and interpretation of the results. This review addresses the need for integration of PD-L1 immunohistochemistry with other tests as part of locally agreed pathways and protocols. There remain areas of uncertainty, and guidance should be updated regularly as new information becomes available.
| Type: | Article |
|---|---|
| Title: | PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/his.12996 |
| Publisher version: | http://dx.doi.org/10.1111/his.12996 |
| Language: | English |
| Additional information: | © 2016 The Authors. Histopathology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Cell Biology, Pathology, Immunohistochemistry, Immunotherapy, Non-Small-Cell Lung Cancer, Programmed Death Ligand 1, Programmed Death Receptor 1, Quality Assurance, Specimen Handling, Treatment Stratification, Core-Needle Biopsy, Clinical-Trials, EBUS-TBNA, Feasibility, Multicenter, Impact |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1511083 |
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