Institute for Pathology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Department of Medicine II (Oncology, Gastroenterology, Hepatology and Pulmonology) and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany.
J Cancer Res Clin Oncol. 2023 Nov;149(17):16231-16238. doi: 10.1007/s00432-023-05180-5. Epub 2023 Oct 24.
As a result of the high approval dynamics and the growing number of immuno-oncological concepts, the complexity of treatment decisions and control in the area of cancers of the esophagus, gastroesophageal junction and stomach is constantly increasing. Since the treatment indication for PD-1 inhibitors that are currently approved in the European Union is often linked to the expression of PD-L1 (programmed cell death-ligand 1), the evaluation of tissue-based predictive markers by the pathologist is of crucial importance for treatment stratification. Even though the immunohistochemical analysis of the PD-L1 expression status is one of the best studied, therapy-relevant biomarkers for an immuno-oncological treatment, due to the high heterogeneity of carcinomas of the upper gastrointestinal tract, there are challenges in daily clinical diagnostic work with regard to implementation, standardization and interpretation of testing. An interdisciplinary group of experts from Germany has taken a position on relevant questions from daily pathological and clinical practice, which concern the starting material, quality-assured testing and the interpretation of pathological findings, and has developed recommendations for structured reporting.
由于高批准率和越来越多的免疫肿瘤学概念，食管、胃食管交界处和胃的癌症治疗决策和控制的复杂性在不断增加。由于目前在欧盟获得批准的 PD-1 抑制剂的治疗指征通常与 PD-L1（程序性细胞死亡配体 1）的表达有关，因此病理学家对基于组织的预测标志物的评估对于治疗分层至关重要。尽管免疫组织化学分析 PD-L1 表达状态是免疫肿瘤学治疗中研究最多的治疗相关生物标志物之一，但由于上消化道癌的高度异质性，在日常临床诊断工作中，在实施、标准化和解释检测方面存在挑战。来自德国的一个多学科专家小组针对日常病理和临床实践中的相关问题采取了立场，这些问题涉及起始材料、质量保证测试以及病理发现的解释，并为结构化报告制定了建议。
