通过对转移性非小细胞肺癌中程序性死亡受体配体1（PD-L1）表达进行定量连续评分来优化患者选择，用于免疫肿瘤治疗。
Enhanced patient selection with quantitative continuous scoring of PD-L1 expression for IO treatment in metastatic NSCLC.
作者信息
Lesniak J, Schick M, Kunzke T, Pollastri F, Vigueras-Guillén J P, Hessel H, Haneder S, Sontakke P, DaCosta K, Alleze R, Zimmermann J, Kapil A, Brieu N, Shumilov A, Sade H, Barrett J C, Schmidt G, Stewart R
机构信息
AstraZeneca Computational Pathology GmbH, Munich, Germany.
AstraZeneca Early Oncology Translational Medicine, Oncology R&D, Gaithersburg, MD, USA.
出版信息
NPJ Precis Oncol. 2025 Sep 18;9(1):315. doi: 10.1038/s41698-025-01107-0.
Immune checkpoint inhibitors targeting PD-1/PD-L1 are approved for metastatic non-small-cell lung cancer treatment. In clinical practice, the treatment choice depends on visual scoring of PD-L1, which is subjective and semi-quantitative. In this work, we present PD-L1 Quantitative Continuous Scoring (PD-L1 QCS), a computer vision system for granular cell-level quantification of PD-L1 staining intensity in digitized whole slide images (WSI). We derived a biomarker which captures the percentage of tumor cells (TC) with medium to strong staining intensity (PD-L1 QCS-PMSTC) and classifies patients with ≥0.575% as biomarker positive (BM+). Its effectiveness was examined against visual scoring of %TC ≥ 50 in 768 WSI from the MYSTIC trial (NCT02453282). Considering anti-PD-L1 treatment (N = 256) vs. chemotherapy (N = 246), visual scoring resulted in a hazard ratio (HR) of 0.69 (CI 0.46-1.02) with a 29.7% prevalence of the BM+ group. With PD-L1 QCS-PMSTC, a similar HR of 0.62 (CI 0.46-0.82) with an increased prevalence of 54.3% was obtained.
靶向PD-1/PD-L1的免疫检查点抑制剂已被批准用于转移性非小细胞肺癌的治疗。在临床实践中，治疗选择取决于PD-L1的视觉评分，这是主观的且半定量的。在这项工作中，我们提出了PD-L1定量连续评分（PD-L1 QCS），这是一种用于在数字化全切片图像（WSI）中对PD-L1染色强度进行颗粒细胞水平定量的计算机视觉系统。我们得出了一种生物标志物，它可以捕获中等至强染色强度的肿瘤细胞（TC）百分比（PD-L1 QCS-PMSTC），并将≥0.575%的患者分类为生物标志物阳性（BM+）。在来自MYSTIC试验（NCT02453282）的768张WSI中，针对%TC≥50的视觉评分检验了其有效性。考虑抗PD-L1治疗组（N = 256）与化疗组（N = 246），视觉评分得出的风险比（HR）为0.69（CI 0.46 - 1.02），BM+组的患病率为29.7%。使用PD-L1 QCS-PMSTC，得到了相似的HR为0.62（CI 0.46 - 0.82），患病率增加到54.3%。
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