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- Title
Discordant PD-L1 results between 28–8 and 22C3 assays are associated with outcomes of gastric cancer patients treated with nivolumab plus chemotherapy.
- Authors
Kim, Hyung-Don; Shin, Jinho; Song, In Hye; Hyung, Jaewon; Lee, Hyungeun; Ryu, Min-Hee; Park, Young Soo
- Abstract
Background: We evaluated the concordance/discordance of PD-L1 staining results between the 28–8 and 22C3 assays and its impact on the efficacy outcomes of advanced gastric cancer patients treated with nivolumab plus chemotherapy. Methods: This retrospective study involved 143 gastric cancer patients treated with first-line nivolumab plus chemotherapy whose PD-L1 results with both 28–8 and 22C3 assays were available. The concordance/discordance between these assays and the inter-observer variability were evaluated for PD-L1 combined positive score (CPS) positivity. Discordant PD-L1 results were analyzed regarding survival outcomes. Results: The agreement rates and Cohen's kappa values between the 28–8 and 22C3 assays were 78.3% and 0.56 (for CPS ≥ 1), 81.8% and 0.60 (for CPS ≥ 5), and 88.8% and 0.66 (for CPS ≥ 10), respectively. Inter-observer variability, as represented by the intra-class correlation coefficient, was 0.89 and 0.88 for the 28–8 and 22C3 assays, respectively. With PD-L1 CPS ≥ 5 defined as positive, 35 (24.5%) and 82 (57.3%) had concordantly positive and negative results, respectively, between the 28–8 and 22C3 assays, whereas 26 (18.2%) had discordant results. Progression-free survival was shorter for those who exhibited negatively concordant PD-L1 results and discordant PD-L1 positivity between the 28–8 and 22C3 assays relative to those with positively concordant PD-L1 results (P = 0.013). Conclusion: PD-L1 assays by 28–8 and 22C3 showed suboptimal concordance, while inter-observer variability was not critical in advanced gastric cancer. Discordant PD-L1 results between 28–8 and 22C3 assays may be associated with unfavorable efficacy outcomes in patients treated with nivolumab plus chemotherapy.
- Subjects
CANCER prognosis; PROGRAMMED death-ligand 1; NIVOLUMAB; INTRACLASS correlation; TREATMENT effectiveness
- Publication
Gastric Cancer, 2024, Vol 27, Issue 4, p819
- ISSN
1436-3291
- Publication type
Article
- DOI
10.1007/s10120-024-01500-x