用于黑色素瘤中纳武单抗治疗的诊断性程序性细胞死亡蛋白1配体1免疫组织化学检测方法的开发

Development of a Diagnostic Programmed Cell Death 1-Ligand 1 Immunohistochemistry Assay for Nivolumab Therapy in Melanoma.

作者信息

Phillips Therese, Millett Molly M, Zhang Xiaoling, Jansson Malinka, Cleveland Rachel, Simmons Pauline, Cherryholmes Gregory, Carnahan Josette, William Josette, Spaulding Betsy, Satnick Ilana R, Inzunza H David, Taylor Clive, Cogswell John, Novotny James, Oroudjev Emin, Winther Henrik

机构信息

Agilent Technologies, Santa Clara.

Spaulding Science Group, Santa Barbara.

出版信息

Appl Immunohistochem Mol Morphol. 2018 Jan;26(1):6-12. doi: 10.1097/PAI.0000000000000605.

Abstract

Nivolumab is a monoclonal antibody that blocks the interaction between programmed cell death 1 (PD1) and programmed cell death 1-ligand 1 (PD-L1), resulting in enhanced antitumor activity by the immune system. Nivolumab is currently approved by the US Food and Drug Administration (FDA) for melanoma, non-small cell lung cancer (NSCLC), renal cell carcinoma, classical Hodgkin lymphoma, squamous cell carcinoma of the head and neck, and urothelial carcinoma. PD-L1 IHC 28-8 pharmDx is FDA-approved as a complementary diagnostic for immunohistochemical (IHC) detection of PD-L1 in non-squamous NSCLC and melanoma. We report validation of PD-L1 IHC 28-8 pharmDx for PD-L1 detection on formalin-fixed, paraffin-embedded human melanoma specimens using Autostainer Link 48. A prevalence assessment of 104 melanoma specimens indicated that PD-L1 was detected across the full expression level range (0% to 100% of tumor cells). Assay robustness and precision studies were conducted at Agilent Technologies, with additional reproducibility studies performed at 3 external laboratories. Precision studies evaluated at ≥1% and ≥5% expression levels revealed a range of average negative agreement from 89.5%, 95% CI (83.2, 93.6) to 100%, 95% CI (97.3, 100), and average positive agreement from 85.5%, 95% CI (77.6, 90.9) to 100%, 95% CI (97.9, 100). For external reproducibility, precise results were obtained. These results demonstrate PD-L1 IHC 28-8 pharmDx is a precise, robust, and reproducible assay for determining PD-L1 expression in melanoma. This is the first PD-L1 IHC test to receive FDA approval as a complementary diagnostic in melanoma patients whereby positive PD-L1 expression is correlated with the magnitude of nivolumab treatment effect.

摘要

纳武单抗是一种单克隆抗体,可阻断程序性细胞死亡蛋白1(PD1)与程序性细胞死亡蛋白1配体1(PD-L1)之间的相互作用,从而增强免疫系统的抗肿瘤活性。纳武单抗目前已获美国食品药品监督管理局(FDA)批准,用于治疗黑色素瘤、非小细胞肺癌(NSCLC)、肾细胞癌、经典型霍奇金淋巴瘤、头颈部鳞状细胞癌和尿路上皮癌。PD-L1 IHC 28-8 pharmDx已获FDA批准,作为非鳞状NSCLC和黑色素瘤中PD-L1免疫组织化学(IHC)检测的补充诊断方法。我们报告了使用Autostainer Link 48在福尔马林固定、石蜡包埋的人黑色素瘤标本上对PD-L1 IHC 28-8 pharmDx进行PD-L1检测的验证。对104份黑色素瘤标本的患病率评估表明,在整个表达水平范围(0%至100%的肿瘤细胞)内均检测到了PD-L1。在安捷伦科技公司进行了分析稳健性和精密度研究,并在3个外部实验室进行了额外的重现性研究。在≥1%和≥5%表达水平下评估的精密度研究显示,平均阴性一致性范围为89.5%,95%CI(83.2,93.6)至100%,95%CI(97.3,100),平均阳性一致性范围为85.5%,95%CI(77.6,90.9)至100%,95%CI(97.9,100)。对于外部重现性,获得了精确的结果。这些结果表明,PD-L1 IHC 28-8 pharmDx是一种精确、稳健且可重现的检测方法,用于确定黑色素瘤中PD-L1的表达。这是首个获得FDA批准作为黑色素瘤患者补充诊断的PD-L1 IHC检测方法,其中PD-L阳性表达与纳武单抗治疗效果的大小相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b254/5753812/bfefc0b59878/pai-26-06-g001.jpg

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