TY - JOUR
T1 - Interobserver agreement of PD-L1 (SP263) assessment in advanced NSCLC on cytological smears and histological samples
AU - Ambrosi, Francesca
AU - Giunchi, Francesca
AU - Capizzi, Elisa
AU - Cancellieri, Alessandra
AU - Trisolini, Rocco
AU - Ardizzoni, Andrea
AU - Fiorentino, Michelangelo
AU - Ricci, Costantino
PY - 2022
Y1 - 2022
N2 - Background: The PD-L1 assessment is mandatory for the selection of patients affected by advanced non-small-cell lung cancer (NSCLC) who can benefit from the PD-1/PD-L1 checkpoint inhibitors therapy. Previous studies tested PD-L1 on cytological smears to evaluate this sample as an alternative to formalin-fixed paraffin-embedded (FFPE) ones, but several critical issues needed to be clarified.Aim: We evaluated the cyto-histological agreement (CHA) and the PD-L1 interobserver agreement (IrOA) among three different pathologists (Path1, Path2, Path3) on 160 paired cytological smears and histological samples of advanced NSCLC.Results: With the cut-off of < 50%/> 50%, CHA resulted good for Path1 (Cohen's k: 0.702) and Path3 (Cohen's k: 0.731), moderate for Path2 (Cohen's k: 0.576) adopting the same cut-off, the IrOA was moderate (ICC 0.72 [95% CI: 0.63-0.78]) for smears and good for histological samples (ICC 0.85 [95% CI: 0.80-0.85]).Conclusion: With a cut-off system of < 50%/> 50%, PD-L1 assessment shows moderate to good CHA and exhibited moderate IrOA on smears and good IrOA on FFPE. As result, PD-L1 assessment should be improved on cytological smears as well as could be a suitable alternative for patients without FFPE samples and not eligible for pembrolizumab, adopting a cut-off of < 50%/> 50%; presumably, an appropriate pathologist training could further improve the reproducibility.
AB - Background: The PD-L1 assessment is mandatory for the selection of patients affected by advanced non-small-cell lung cancer (NSCLC) who can benefit from the PD-1/PD-L1 checkpoint inhibitors therapy. Previous studies tested PD-L1 on cytological smears to evaluate this sample as an alternative to formalin-fixed paraffin-embedded (FFPE) ones, but several critical issues needed to be clarified.Aim: We evaluated the cyto-histological agreement (CHA) and the PD-L1 interobserver agreement (IrOA) among three different pathologists (Path1, Path2, Path3) on 160 paired cytological smears and histological samples of advanced NSCLC.Results: With the cut-off of < 50%/> 50%, CHA resulted good for Path1 (Cohen's k: 0.702) and Path3 (Cohen's k: 0.731), moderate for Path2 (Cohen's k: 0.576) adopting the same cut-off, the IrOA was moderate (ICC 0.72 [95% CI: 0.63-0.78]) for smears and good for histological samples (ICC 0.85 [95% CI: 0.80-0.85]).Conclusion: With a cut-off system of < 50%/> 50%, PD-L1 assessment shows moderate to good CHA and exhibited moderate IrOA on smears and good IrOA on FFPE. As result, PD-L1 assessment should be improved on cytological smears as well as could be a suitable alternative for patients without FFPE samples and not eligible for pembrolizumab, adopting a cut-off of < 50%/> 50%; presumably, an appropriate pathologist training could further improve the reproducibility.
KW - NSCLC
KW - PD-L1
KW - cytological smears
KW - immunohistochemistry
KW - interobserver agreement
KW - pembrolizumab
KW - NSCLC
KW - PD-L1
KW - cytological smears
KW - immunohistochemistry
KW - interobserver agreement
KW - pembrolizumab
UR - http://hdl.handle.net/10807/222157
U2 - 10.1016/j.prp.2022.153893
DO - 10.1016/j.prp.2022.153893
M3 - Article
SN - 0344-0338
VL - 233
SP - 153893
EP - 153896
JO - Pathology Research and Practice
JF - Pathology Research and Practice
ER -