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- Title
Digital slides as an effective tool for programmed death ligand 1 combined positive score assessment and training: Lessons learned from the "Programmed death ligand 1 key learning program in Head-and-Neck squamous cell carcinoma".
- Authors
Eccher, Albino; Fontanini, Gabriella; Fusco, Nicola; Girolami, Ilaria; Graziano, Paolo; Rocco, Elena; Martini, Maurizio; Morbini, Patrizia; Pantanowitz, Liron; Parwani, Anil; Pisano, Anna; Troncone, Giancarlo; Vigliar, Elena
- Abstract
Specifically, PD-L1 IHC was scored as summarized in [Table 1].[[16]]{Table 1} For this analysis, any convincing partial or complete linear membrane staining (>=1+) of viable tumor cells that is perceived as distinct from cytoplasmic staining was considered to represent PD-L1 staining and included in scoring. Introduction Head-and-neck squamous cell carcinoma (HNSCC) affects approximately 830,000 people each year worldwide.[[1]] Despite using combinations of surgery, radiotherapy, and chemotherapy, the 5-year overall survival of HNSCC is only 40%-50%.[[2]] The programmed death 1 (PD-l)/programmed death ligand 1 (PD-L1) axis has emerged as a key mechanism of immune escape by HNSCC.[[3]] This immune checkpoint system can accordingly be targeted with specific drugs blocking the tumor's immunosuppressive signaling, thus boosting the antitumor immune response.[[4]] Several methods have been proposed for PD-L1 status assessment by immunohistochemistry (IHC) including the use of a combined positive score (CPS).[[5]] This integrated scoring system considers the expression of this immune checkpoint biomarker on the cell membrane of both tumor and tumor-associated inflammatory cells.[[6]] Recent trials investigating the efficacy of first-line immune-checkpoint inhibition with the anti-PD-1 drug pembrolizumab in recurrent and/or metastatic HNSCC (KEYNOTE-048 and KEYNOTE-012) showed that PD-L1 expression is associated with an increased objective response rate, with better response when CPS >=20.[[7]],[[8]] Around 50%-60% of HNSCC tumor cells express PD-L1 when assessed with tumor proportion score,[[9]] but this percentage increases to 85% when considering both tumor and surrounding immune cells (as measured with CPS).[[8]] The two different modalities of assessment partly explain the different prevalence of PD-L1 expression.
- Subjects
PROGRAMMED cell death 1 receptors; SQUAMOUS cell carcinoma
- Publication
Journal of Pathology Informatics, 2021, p1
- ISSN
2229-5089
- Publication type
Article
- DOI
10.4103/jpi.jpi_63_20