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Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation

Programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) inhibition has revolutionized the treatment paradigm of urothelial carcinoma (UC). Several PD-L1 assays are conducted to formulate appropriate treatment decisions for PD-1/PD-L1 target therapy in UC. However, each assay has its o...

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Autores principales: Lee, Kyu Sang, Choe, Gheeyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Pathologists and the Korean Society for Cytopathology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141973/
https://www.ncbi.nlm.nih.gov/pubmed/33823566
http://dx.doi.org/10.4132/jptm.2021.02.22
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author Lee, Kyu Sang
Choe, Gheeyoung
author_facet Lee, Kyu Sang
Choe, Gheeyoung
author_sort Lee, Kyu Sang
collection PubMed
description Programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) inhibition has revolutionized the treatment paradigm of urothelial carcinoma (UC). Several PD-L1 assays are conducted to formulate appropriate treatment decisions for PD-1/PD-L1 target therapy in UC. However, each assay has its own specific requirement of antibody clones, staining platforms, scoring algorithms, and cutoffs for the determination of PD-L1 status. These prove to be challenging constraints to pathology laboratories and pathologists. Thus, the present article comprehensively demonstrates the scoring algorithm used and differences observed in each assay (22C3, SP142, and SP263). Interestingly, the SP142 score algorithm considers only immune cells and not tumor cells (TCs). It remains controversial whether SP142 expressed only in TCs truly accounts for a negative PD-L1 case. Moreover, the scoring algorithm of each assay is complex and divergent, which can result in inter-observer heterogeneity. In this regard, the development of artificial intelligence for providing assistance to pathologists in obtaining more accurate and objective results has been actively researched. To facilitate efficiency of PD-L1 testing, several previous studies attempted to integrate and harmonize each assay in UC. The performance comparison of the various PD-L1 assays demonstrated in previous studies was encouraging, the exceptional concordance rate reported between 22C3 and SP263. Although these two assays may be used interchangeably, a clinically validated algorithm for each agent must be applied.
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spelling pubmed-81419732021-06-04 Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation Lee, Kyu Sang Choe, Gheeyoung J Pathol Transl Med Review Programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) inhibition has revolutionized the treatment paradigm of urothelial carcinoma (UC). Several PD-L1 assays are conducted to formulate appropriate treatment decisions for PD-1/PD-L1 target therapy in UC. However, each assay has its own specific requirement of antibody clones, staining platforms, scoring algorithms, and cutoffs for the determination of PD-L1 status. These prove to be challenging constraints to pathology laboratories and pathologists. Thus, the present article comprehensively demonstrates the scoring algorithm used and differences observed in each assay (22C3, SP142, and SP263). Interestingly, the SP142 score algorithm considers only immune cells and not tumor cells (TCs). It remains controversial whether SP142 expressed only in TCs truly accounts for a negative PD-L1 case. Moreover, the scoring algorithm of each assay is complex and divergent, which can result in inter-observer heterogeneity. In this regard, the development of artificial intelligence for providing assistance to pathologists in obtaining more accurate and objective results has been actively researched. To facilitate efficiency of PD-L1 testing, several previous studies attempted to integrate and harmonize each assay in UC. The performance comparison of the various PD-L1 assays demonstrated in previous studies was encouraging, the exceptional concordance rate reported between 22C3 and SP263. Although these two assays may be used interchangeably, a clinically validated algorithm for each agent must be applied. The Korean Society of Pathologists and the Korean Society for Cytopathology 2021-05 2021-04-07 /pmc/articles/PMC8141973/ /pubmed/33823566 http://dx.doi.org/10.4132/jptm.2021.02.22 Text en © 2021 The Korean Society of Pathologists/The Korean Society for Cytopathology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Lee, Kyu Sang
Choe, Gheeyoung
Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title_full Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title_fullStr Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title_full_unstemmed Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title_short Programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
title_sort programmed cell death-ligand 1 assessment in urothelial carcinoma: prospect and limitation
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141973/
https://www.ncbi.nlm.nih.gov/pubmed/33823566
http://dx.doi.org/10.4132/jptm.2021.02.22
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