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Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record

A meeting among expert pathologists was held in 2019 in Rome to verify the results of the previous harmonization efforts on the PD-L1 immunohistochemical testing by scoring a representative series of non-small cell lung cancer (NSCLC) digital slides. The current paper shows the results of this digit...

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Autores principales: Pagni, Fabio, Malapelle, Umberto, Doglioni, Claudio, Fontanini, Gabriella, Fraggetta, Filippo, Graziano, Paolo, Marchetti, Antonio, Guerini Rocco, Elena, Pisapia, Pasquale, Vigliar, Elena V., Buttitta, Fiamma, Jaconi, Marta, Fusco, Nicola, Barberis, Massimo, Troncone, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408471/
https://www.ncbi.nlm.nih.gov/pubmed/32635634
http://dx.doi.org/10.3390/cancers12071800
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author Pagni, Fabio
Malapelle, Umberto
Doglioni, Claudio
Fontanini, Gabriella
Fraggetta, Filippo
Graziano, Paolo
Marchetti, Antonio
Guerini Rocco, Elena
Pisapia, Pasquale
Vigliar, Elena V.
Buttitta, Fiamma
Jaconi, Marta
Fusco, Nicola
Barberis, Massimo
Troncone, Giancarlo
author_facet Pagni, Fabio
Malapelle, Umberto
Doglioni, Claudio
Fontanini, Gabriella
Fraggetta, Filippo
Graziano, Paolo
Marchetti, Antonio
Guerini Rocco, Elena
Pisapia, Pasquale
Vigliar, Elena V.
Buttitta, Fiamma
Jaconi, Marta
Fusco, Nicola
Barberis, Massimo
Troncone, Giancarlo
author_sort Pagni, Fabio
collection PubMed
description A meeting among expert pathologists was held in 2019 in Rome to verify the results of the previous harmonization efforts on the PD-L1 immunohistochemical testing by scoring a representative series of non-small cell lung cancer (NSCLC) digital slides. The current paper shows the results of this digital experimental meeting and the expertise achieved by the community of Italian pathologists. PD-L1 protein expression was determined using tumor proportion score (TPS), i.e., the percentage of viable tumor cells showing partial or complete membrane staining at any intensity. The gold standard was defined as the final PD-L1 score formulated by a panel of seven lung committed pathologists. PD-L1 status was clustered in three categories, namely negative (TPS < 1), low (TPS 1–49%), and high (TPS ≥ 50%). In 23 cases (71.9%) PD-L1 staining was performed using the companion diagnostic 22C3 pharmDx kit on Dako Autostainer, while in nine (28.1%) cases it was performed using the SP263 Ventana kit on BenchMark platform. A complete PD-L1 scoring agreement between the panel of experts and the participants was reached in 57.1% of cases, whereas a minor disagreement in 16.1% of cases was recorded. Italian pathologists performed best in strong positive cases (i.e., tumor proportion score TPS > 50%), whereas only 10.8% of disagreement with the gold standard was observed, and 55.6% regarded a single challenging case. The worst performance was achieved in the negative cases, with 32.0% disagreement. A significant difference resulted from the analysis of the data separated by the different clones used: 22.3% and 38.1% disagreement (p = 0.01) was found in the group of cases analyzed by 22C3 and SP263 antibody clones, respectively. In conclusion, this workshop record proposed the application of a digital pathology platform to share controversial cases in educational meetings as an alternative possibility for improving the interpretation and reporting of specific histological tools. Due to the crucial role of PD-L1 TPS for the selection of patients for immunotherapy, the identification of unconventional approaches as virtual slides to focus experiences and give more detailed practical verifications of the standard quality reached may be a considerable option.
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spelling pubmed-74084712020-08-13 Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record Pagni, Fabio Malapelle, Umberto Doglioni, Claudio Fontanini, Gabriella Fraggetta, Filippo Graziano, Paolo Marchetti, Antonio Guerini Rocco, Elena Pisapia, Pasquale Vigliar, Elena V. Buttitta, Fiamma Jaconi, Marta Fusco, Nicola Barberis, Massimo Troncone, Giancarlo Cancers (Basel) Article A meeting among expert pathologists was held in 2019 in Rome to verify the results of the previous harmonization efforts on the PD-L1 immunohistochemical testing by scoring a representative series of non-small cell lung cancer (NSCLC) digital slides. The current paper shows the results of this digital experimental meeting and the expertise achieved by the community of Italian pathologists. PD-L1 protein expression was determined using tumor proportion score (TPS), i.e., the percentage of viable tumor cells showing partial or complete membrane staining at any intensity. The gold standard was defined as the final PD-L1 score formulated by a panel of seven lung committed pathologists. PD-L1 status was clustered in three categories, namely negative (TPS < 1), low (TPS 1–49%), and high (TPS ≥ 50%). In 23 cases (71.9%) PD-L1 staining was performed using the companion diagnostic 22C3 pharmDx kit on Dako Autostainer, while in nine (28.1%) cases it was performed using the SP263 Ventana kit on BenchMark platform. A complete PD-L1 scoring agreement between the panel of experts and the participants was reached in 57.1% of cases, whereas a minor disagreement in 16.1% of cases was recorded. Italian pathologists performed best in strong positive cases (i.e., tumor proportion score TPS > 50%), whereas only 10.8% of disagreement with the gold standard was observed, and 55.6% regarded a single challenging case. The worst performance was achieved in the negative cases, with 32.0% disagreement. A significant difference resulted from the analysis of the data separated by the different clones used: 22.3% and 38.1% disagreement (p = 0.01) was found in the group of cases analyzed by 22C3 and SP263 antibody clones, respectively. In conclusion, this workshop record proposed the application of a digital pathology platform to share controversial cases in educational meetings as an alternative possibility for improving the interpretation and reporting of specific histological tools. Due to the crucial role of PD-L1 TPS for the selection of patients for immunotherapy, the identification of unconventional approaches as virtual slides to focus experiences and give more detailed practical verifications of the standard quality reached may be a considerable option. MDPI 2020-07-05 /pmc/articles/PMC7408471/ /pubmed/32635634 http://dx.doi.org/10.3390/cancers12071800 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pagni, Fabio
Malapelle, Umberto
Doglioni, Claudio
Fontanini, Gabriella
Fraggetta, Filippo
Graziano, Paolo
Marchetti, Antonio
Guerini Rocco, Elena
Pisapia, Pasquale
Vigliar, Elena V.
Buttitta, Fiamma
Jaconi, Marta
Fusco, Nicola
Barberis, Massimo
Troncone, Giancarlo
Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title_full Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title_fullStr Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title_full_unstemmed Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title_short Digital Pathology and PD-L1 Testing in Non Small Cell Lung Cancer: A Workshop Record
title_sort digital pathology and pd-l1 testing in non small cell lung cancer: a workshop record
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408471/
https://www.ncbi.nlm.nih.gov/pubmed/32635634
http://dx.doi.org/10.3390/cancers12071800
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