National Center for Drug Research and Evaluation, National Institute of Health (ISS), Rome 00161, Italy.
Center for Thoracic Oncology/Tisch Cancer Institute and Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Crit Rev Oncol Hematol. 2024 Aug;200:104401. doi: 10.1016/j.critrevonc.2024.104401. Epub 2024 May 28.
Several observations indicate that protein expression analysis by immunohistochemistry (IHC) remains relevant in individuals with non-small-cell lung cancer (NSCLC) when considering targeted therapy, as an early step in diagnosis and for therapy selection. Since the advent of next-generation sequencing (NGS), the role of IHC in testing for NSCLC biomarkers has been forgotten or ignored. We discuss how protein-level investigations maintain a critical role in defining sensitivity to lung cancer therapies in oncogene- and non-oncogene-addicted cases and in patients eligible for immunotherapy, suggesting that IHC testing should be reconsidered in clinical practice. We also argue how a panel of IHC tests should be considered complementary to NGS and other genomic assays. This is relevant to current clinical diagnostic practice but with potential future roles to optimize the selection of patients for innovative therapies. At the same time, strict validation of antibodies, assays, scoring systems, and intra- and interobserver reproducibility is needed.
有几点观察结果表明，在考虑靶向治疗时，非小细胞肺癌（NSCLC）患者的免疫组织化学（IHC）蛋白表达分析仍然具有相关性，可作为诊断的早期步骤和治疗选择的依据。自下一代测序（NGS）出现以来，IHC 在检测 NSCLC 生物标志物方面的作用已被遗忘或忽视。我们讨论了蛋白水平的研究如何在确定对致癌基因和非致癌基因依赖的情况下以及对免疫疗法有资格的患者的肺癌治疗的敏感性方面保持关键作用，表明在临床实践中应重新考虑 IHC 检测。我们还论证了一组 IHC 检测应如何被视为与 NGS 和其他基因组检测互补。这与当前的临床诊断实践有关，但具有潜在的未来作用，可以优化为创新疗法选择患者。同时，需要严格验证抗体、检测、评分系统以及观察者内和观察者间的可重复性。
