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Review
. 2020 Apr;15(4):499-519.
doi: 10.1016/j.jtho.2019.12.107. Epub 2019 Dec 20.

PD-L1 Testing for Lung Cancer in 2019: Perspective From the IASLC Pathology Committee

Sylvie Lantuejoul  1 , Ming Sound-Tsao  2 , Wendy A Cooper  3 , Nicolas Girard  4 , Fred R Hirsch  5 , Anja C Roden  6 , Fernando Lopez-Rios  7 , Deepali Jain  8 , Teh-Ying Chou  9 , Noriko Motoi  10 , Keith M Kerr  11 , Yasushi Yatabe  10 , Elisabeth Brambilla  12 , John Longshore  13 , Mauro Papotti  14 , Lynette M Sholl  15 , Erik Thunnissen  16 , Natasha Rekhtman  17 , Alain Borczuk  18 , Lukas Bubendorf  19 , Yuko Minami  20 , Mary Beth Beasley  21 , Johan Botling  22 , Gang Chen  23 , Jin-Haeng Chung  24 , Sanja Dacic  25 , David Hwang  26 , Dongmei Lin  27 , Andre Moreira  28 , Andrew G Nicholson  29 , Masayuki Noguchi  30 , Giuseppe Pelosi  31 , Claudia Poleri  32 , William Travis  17 , Akihiko Yoshida  10 , Jillian B Daigneault  33 , Ignacio I Wistuba  34 , Mari Mino-Kenudson  35
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Free article
Review

PD-L1 Testing for Lung Cancer in 2019: Perspective From the IASLC Pathology Committee

Sylvie Lantuejoul et al. J Thorac Oncol. 2020 Apr.
Free article

Abstract

The recent development of immune checkpoint inhibitors (ICIs) has led to promising advances in the treatment of patients with NSCLC and SCLC with advanced or metastatic disease. Most ICIs target programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) axis with the aim of restoring antitumor immunity. Multiple clinical trials for ICIs have evaluated a predictive value of PD-L1 protein expression in tumor cells and tumor-infiltrating immune cells (ICs) by immunohistochemistry (IHC), for which different assays with specific IHC platforms were applied. Of those, some PD-L1 IHC assays have been validated for the prescription of the corresponding agent for first- or second-line treatment. However, not all laboratories are equipped with the dedicated platforms, and many laboratories have set up in-house or laboratory-developed tests that are more affordable than the generally expensive clinical trial-validated assays. Although PD-L1 IHC test is now deployed in most pathology laboratories, its appropriate implementation and interpretation are critical as a predictive biomarker and can be challenging owing to the multiple antibody clones and platforms or assays available and given the typically small size of samples provided. Because many articles have been published since the issue of the IASLC Atlas of PD-L1 Immunohistochemistry Testing in Lung Cancer, this review by the IASLC Pathology Committee provides updates on the indications of ICIs for lung cancer in 2019 and discusses important considerations on preanalytical, analytical, and postanalytical aspects of PD-L1 IHC testing, including specimen type, validation of assays, external quality assurance, and training.

Keywords: Immunohistochemistry; Immunotherapy; NSCLC; PD-L1; SCLC.

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