Performance of endobronchial ultrasound transbronchial needle aspiration as the first nodal staging procedure for the determination of programmed death ligand-1 expression in non-small cell lung cancer patients.

Autor: Polanco D; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain., Pinilla L; Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain., Gracia-Lavedan E; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain., Gatius S; Pathology Department, University Hospital Arnau de Vilanova, Lleida, Spain., Zuil M; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain., Pardina M; Radiology Department, University Hospital Arnau de Vilanova, Lleida, Spain., Gómez S; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain., Barbé F; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain. febarbe.lleida.ics@gencat.cat.; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. febarbe.lleida.ics@gencat.cat.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 Oct; Vol. 149 (13), pp. 12459-12468. Date of Electronic Publication: 2023 Jul 14.
DOI: 10.1007/s00432-023-05039-9
Abstrakt: Purpose: The determination of the programmed death ligand-1 (PD-L1) expression is part of the diagnostic algorithm for advanced non-small cell lung cancer (NSCLC) patients. We aimed to analyze the diagnostic performance of EBUS-TBNA performed as first-choice nodal staging procedure for the determination of PD-L1 expression in NSCLC patients.
Methods: Longitudinal-prospective study including NSCLC patients diagnosed between January 2018 and October 2019, for whom a primary tumor biopsy sample and an EBUS-TBNA cytological malignant sample were available. Samples with fewer than 100 malignant cells were considered inadequate. PDL-1 IHC 22C3 pharmDx antibody was used. The percentage of tumor cells expressing PD-L1, setting 1% and 50% as cutoff points, was collected. The weighted kappa coefficient was used to assess the concordance of PD-L1 expression. The PD-L1 expression was compared in precision terms.
Results: From a total of 43 patients, 53 pairs of samples were obtained, of which 23 (43.4%) were adequate and included for analysis. The weighted kappa coefficient for PD-L1 expression was 0.41 (95% CI 0.15-0.68) and 0.56 (95% CI 0.23-0.9) for cutoff values ≥ 1% and ≥ 50%, respectively. In advanced stages, the weighted kappa coefficient was 0.6 (95% CI 0.3-0.9) and 1 (95% CI 1-1) for PD-L1 expression cutoff values ≥ 1% and ≥ 50%, respectively. EBUS-TBNA showed a sensitivity, specificity, positive predictive value, and negative predictive value of 1 to detect PDL-1 expression ≥ 50% in advanced stages.
Conclusion: EBUS-TBNA performed as first nodal staging procedure in advanced NSCLC patients provides reliable specimens for the detection of PD-L1 expression ≥ 50% and could guide immunotherapy.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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