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PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation

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. Green open access

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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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