Institute of Pathology, Carl Gustav Carus University Hospital Dresden, 01307 Dresden, Germany.
Targos Molecular Pathology GmbH, 34119 Kassel, Germany.
Curr Oncol. 2021 Dec 8;28(6):5227-5239. doi: 10.3390/curroncol28060437.
In recent years, the treatment of non-small-cell lung cancer (NSCLC) has been fundamentally changed by immunotherapy where the immune system is reactivated using anti-programmed cell death protein 1/programmed death ligand 1 (PD1/PD-L1) checkpoint inhibition. With this, the immunohistological detection of PD-L1 has become one of the most important predictive biomarkers, leading pathologists to play a central role in the immuno-oncological therapy decisions. This has brought them the challenge of requiring the knowledge of relevant checkpoint inhibitors (CI), different PD-L1 scores and cut-offs as well as the choice of the right tissues and controls. Their involvement is also required in the careful validation of both clinical trial assays (CTAs) and laboratory developed tests (LDTs), in addition to the internal and external quality assessment and the interpretation and scoring of the staining based on specialist training. After the training of tumor proportion score (TPS) scoring in NSCLC, pathologists show a high level of concordance, with some variation between different cut-offs. Since not all patients benefit from immunotherapy, further research is needed to validate new predictive markers and optimize existing ones. In this context, these studies focus on a combination of PD-L1 and molecular signatures.
近年来，非小细胞肺癌（NSCLC）的治疗方法发生了根本性的变化，通过免疫疗法重新激活免疫系统，使用抗程序性细胞死亡蛋白 1/程序性死亡配体 1（PD1/PD-L1）检查点抑制剂。因此，PD-L1 的免疫组织化学检测已成为最重要的预测生物标志物之一，使病理学家在免疫肿瘤治疗决策中发挥核心作用。这给他们带来了挑战，需要了解相关的检查点抑制剂（CI）、不同的 PD-L1 评分和截止值，以及选择正确的组织和对照。他们还需要参与仔细验证临床试验检测（CTA）和实验室开发的检测（LDT），以及内部和外部质量评估以及基于专业培训的染色解释和评分。在对非小细胞肺癌的肿瘤比例评分（TPS）评分进行培训后，病理学家表现出高度的一致性，不同截止值之间存在一些差异。由于并非所有患者都受益于免疫治疗，因此需要进一步研究来验证新的预测标志物并优化现有的标志物。在这种情况下，这些研究侧重于 PD-L1 和分子特征的组合。
