TY - JOUR
T1 - PD-L1 assessment in cytology samples predicts treatment response to checkpoint inhibitors in NSCLC
AU - Lau, Sally C.M.
AU - Rabindranath, Madhumitha
AU - Weiss, Jessica
AU - Li, Janice J.N.
AU - Fung, Andrea S.
AU - Mullen, Dorinda
AU - Alshamlan, Najd
AU - Ruff, Heather M.
AU - Tong, Leung Chu B.
AU - Pal, Prodipto
AU - Cabanero, Michael R.
AU - Hsu, Ying Han R.
AU - Sacher, Adrian G.
AU - Shepherd, Frances A.
AU - Liu, Geoffrey
AU - Bradbury, Penelope A.
AU - Yasufuku, Kazuhiro
AU - Czarnecka-Kujawa, Katarzyna
AU - Mi Ko, Hyang
AU - Tsao, Ming Sound
AU - Leighl, Natasha B.
AU - Schwock, Joerg
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Testing for tumor programmed death ligand-1 (PD-L1) expression was initially developed with histology specimens in non-small cell lung cancer (NSCLC). However, cytology specimens are widely used for primary diagnosis and biomarker studies in clinical practice. Limited clinical data exist on the predictiveness of cytology-derived PD-L1 scores for response to immune checkpoint inhibitor (ICI) therapy. Methods: We reviewed all NSCLC specimens clinically tested at the University Health Network (UHN) for PD-L1 with 22C3 pharmDx, from 01/2013 to 04/2021. Treatment outcomes in patients treated with single agent ICI therapy were reviewed and compared according to cytology- and histology-derived PD-L1 scores. Results: We identified 494 and 1942 unique patients with cytology- and histology-derived tumor proportion scores, respectively, during the study period. Informative testing rates were 95 % vs 98 % for cytology and histology, respectively. Clinical data were available for 152 patients treated with single agent ICI: 61 cytology and 91 histology. Overall response rates (ORR) were similar for cytology and histology (36 % vs 34 %; p = 0.23), as well as median progression free survival (PFS) (4.9 vs 4.2 months; p = 0.99) and overall survival (23.4 vs 19.7 months; p = 0.99). The results remained similar even after adjusting for PD-L1 expression levels and line of ICI treatment (PFS HR 1.15; 95 %CI 0.78–1.70; p = 0.47). Conclusions: Treatment outcomes to single agent ICI based on cytology-derived PD-L1 scores were comparable to histology controls. Our results support PD-L1 biomarker testing on both cytology and histology specimens.
AB - Background: Testing for tumor programmed death ligand-1 (PD-L1) expression was initially developed with histology specimens in non-small cell lung cancer (NSCLC). However, cytology specimens are widely used for primary diagnosis and biomarker studies in clinical practice. Limited clinical data exist on the predictiveness of cytology-derived PD-L1 scores for response to immune checkpoint inhibitor (ICI) therapy. Methods: We reviewed all NSCLC specimens clinically tested at the University Health Network (UHN) for PD-L1 with 22C3 pharmDx, from 01/2013 to 04/2021. Treatment outcomes in patients treated with single agent ICI therapy were reviewed and compared according to cytology- and histology-derived PD-L1 scores. Results: We identified 494 and 1942 unique patients with cytology- and histology-derived tumor proportion scores, respectively, during the study period. Informative testing rates were 95 % vs 98 % for cytology and histology, respectively. Clinical data were available for 152 patients treated with single agent ICI: 61 cytology and 91 histology. Overall response rates (ORR) were similar for cytology and histology (36 % vs 34 %; p = 0.23), as well as median progression free survival (PFS) (4.9 vs 4.2 months; p = 0.99) and overall survival (23.4 vs 19.7 months; p = 0.99). The results remained similar even after adjusting for PD-L1 expression levels and line of ICI treatment (PFS HR 1.15; 95 %CI 0.78–1.70; p = 0.47). Conclusions: Treatment outcomes to single agent ICI based on cytology-derived PD-L1 scores were comparable to histology controls. Our results support PD-L1 biomarker testing on both cytology and histology specimens.
KW - Cytology
KW - Immune checkpoint inhibitors
KW - Immunohistochemistry
KW - Non-small cell lung cancer
KW - PD-L1 testing
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U2 - 10.1016/j.lungcan.2022.07.018
DO - 10.1016/j.lungcan.2022.07.018
M3 - Article
C2 - 35907387
AN - SCOPUS:85135012794
SN - 0169-5002
VL - 171
SP - 42
EP - 46
JO - Lung Cancer
JF - Lung Cancer
ER -