Perrotta, F;
Nankivell, M;
Adizie, B;
Maqsood, U;
Elshafi, M;
Jafri, S;
Lerner, AD;
... Navani, N; + view all
(2020)
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for PD-L1 Testing In Non-Small Cell Lung Cancer.
Chest
, 158
(3)
pp. 1230-1239.
10.1016/j.chest.2020.04.059.
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Abstract
Rationale: PD-L1 expression on cancer cells is a clinically important biomarker to select NSCLC patients for treatment with PD-1/PD-L1 inhibitors. Clinical trials of immunotherapy in patients with non-small cell lung cancer have required histology for PD-L1 testing, while in clinical practice cytology samples are commonly acquired in patients with advanced disease. / Objectives: This study investigates sampling adequacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for PD-L1 testing when compared to other methods. Furthermore, the relationship between clinico-pathological characteristics and PD-L1 expression in the study population have been examined. / Methods: Five hundred seventy-seven NSCLC specimens were analysed from consecutive patients with NSCLC across six centres in United Kingdom and one in the United States between January 2015 and December 2016. / Main Results: In the EBUS-TBNA group (189 specimens), the overall percentage of patients with successful PD-L1 testing was 94.7%. There was no significant difference in sampling adequacy with other methods of tissue acquisition. Older subjects had higher failure rates of PD-L1 testing (OR= 1.06, p=0.008). In multivariate analysis, advanced N-stage (p=0.048) and presence of brain metastasis (p<0.001) were associated with high PD-L1 expression. / Conclusion: This large multicenter study shows that EBUS-TBNA provides samples adequate for PD-L1 testing and that advanced N stage and the presence of brain metastasis are associated with high PD-L1 expression.
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