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• W2893531902 abstract "We thank Bravaccini and Bronte for raising the issue of performing testing for programmed death-ligand 1 (PD-L1) expression on cytology smears. Our recent article on the cytologic-histologic correlation of PD-L1 immunohistochemistry in lung carcinomas included the results of PD-L1 staining for 56 cell blocks only.1 Because antibodies that target programmed death 1 (PD1) or PD-L1 may represent the only therapeutic recourse for a subset of patients with advanced non–small cell lung cancer, we agree that the possibility of testing multiple types of specimen preparations is interesting. Cytology practice is unique in its use of different preparation methods for any given specimen, providing multiple possible substrates for immunostaining in each case. The option of testing different preparations is particularly attractive in cases in which there may be more material on one preparation than another. For this reason, among others, cell blocks, smears, liquid-based preparations (eg, ThinPrep and SurePath), and cytospin preparations are all routinely used for immunocytochemistry by individual laboratories in the United States and Europe.2, 3 However, different cytologic preparation methods are associated with different pre-analytic variables, such as the use of different fixatives, which, as Bravaccini and Bronte also point out, may affect immunocytochemical staining.4 The development of appropriate controls poses another potential challenge to the development and interpretation of these assays. In addition, the presence of background material and the 3-dimensional arrangement of cells may make the interpretation of stains difficult for pathologists who are not used to interpreting immunocytochemistry on different preparations.4 The practical challenges of performing immunocytochemistry on different cytology preparations highlights the importance of rigorous method validation by laboratories that choose to do so, particularly when they are using predictive biomarkers that, like PD-L1, use a strict diagnostic threshold. One must also consider that the variability inherent in using different preparations for staining may add to the variability in the performance of different PD-L1 assays and thereby pose further obstacles to the standardization of PD-L1 evaluation across institutions. Nevertheless, a recent article by Noll et al5 has shown good concordance of PD-L1 staining between smears and surgical specimens and supports their use for the assessment of PD-L1 under appropriate circumstances. We look forward to further investigation and discussion of this topic. No specific funding was disclosed. The authors made no disclosures." @default.
• W2893531902 created "2018-10-05" @default.
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• W2893531902 date "2018-09-01" @default.
• W2893531902 modified "2023-10-14" @default.
• W2893531902 title "Reply to Petals and thorns in programmed death-ligand 1 testing: Is all non-small cell lung cancer diagnostic material suitable?" @default.
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• W2893531902 doi "https://doi.org/10.1002/cncy.22032" @default.
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