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- W3138115459 abstract "Immune checkpoint inhibitors are the new key players in lung cancer management. Increasing demands for PD-LI (Programmed Death-Ligand 1) testing has been observed recently and its role is emerging as a potential biomarker for immunotherapy. However, there is the paucity of the Indian data on the prevalence of PDL1 expression. This study was undertaken with an objective to evaluate the prevalence of PD-L1 expression in lung cancer patients and analyze its correlation with clinicopathological factors All cases of histologically proven lung cancer, diagnosed between January 2017–November 2019, wherein PD-L1 testing was performed were retrieved from electronic medical records. PDL-1 Testing was performed using rabbit Anti-Human PD-L1 monoclonal antibody (Ventana clone SP263) on VENTANA BENCHMARK XT Auto-immmunostainer. Membranous PD-L1 expression of >/ =1% in the tumour cells was regarded as positive. Prevalence of PD-L1 expression and its correlation with clinic-pathological factors were recorded. Further, stratification of the cases was done, in subgroups of: Negative PDL1 (0/<1% PD-L1 expression), low PDL1 expression (1 – 49%) and high PD-L1 expression (> =50%). The intensity of expression was recorded as weak, moderate & Strong Out of total 627 clinical request for PDL1 testing in lung cancer during this period, the results could be analyzed in 568 cases (In 35 cases the test could not be performed due to inadequate tumour content and in 23 cases although the test was performed, but could not be interpreted due to technical and interpretative issues). Hence the study cohort comprised of 568 cases. The median age was 56.95 years (range: 29-83years) with male predominance (M:F ratio-2.4:1) and advanced clinical stage III/IV [482(84.8%)]. Smoking history was present in 340 cases (59%). Lung biopsies were the most common type of specimen (n=351,61.7%) followed by metastatic lymph nodes (n=101, 17.8%), effusion cytology cell block (n=36, 6.3%) liver (n=33,5.8%) and others metastatic sites (n=40, 7%). Adenocarcinoma was predominant histological subtype (n=437,76.9%) followed by squamous cell carcinoma (n=87, 15.3%), NSCLC (n=13, 2.28%), small cell carcinoma (n=12, 2.11%) and others(n=19,3.34%). Overall 57.5 %(n=327/568) of cases revealed PD-L1 positivity (> 1% expression of any intensity) including low PDL1 expression (1-50%) in 37.6 %(n=214) and high PDL1 expression (>50%) was seen in 19.8%(n=113). Almost one-third of positive cases (n=110/327, 33.6%), the PDL1 expression was very low i.e. < 10 % of tumour cells. Most of the cases revealed IHC expression of moderate-intensity (n=160, 48.9%) followed by weak(n=85,26%) and strong intensity in 82 cases (25%). Heterogeneous expression was noted in 74 cases (22.6%). The expression was greater in tumours with squamous histology, smokers and female patients. Further, PDL-1 positivity rates were higher in EGFR mutated tumors70/124(66.7%) as opposed to EGFR wild tumours 224/362(41.9%) This was the first comprehensive study on the prevalence of PD-L1 expression in Indian lung cancer population demonstrating real-world data. Although the overall positivity rate of PD-L1 expression was 58%, only 19% of cases had high expression i. e in > 50 % tumour cells. Heterogeneity in PD-L1 staining is a crucial factor affecting its evaluation. The findings reinforces the utility of PDL1 testing in Indian patients for segregation of patients for frontline immune checkpoint inhibitors" @default.
- W3138115459 created "2021-03-29" @default.
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- W3138115459 date "2021-03-01" @default.
- W3138115459 modified "2023-09-28" @default.
- W3138115459 title "P33.18 The Prevalence of PDL-1 Expression in Lung Cancer: Real-World Experience from a Tertiary Care Oncology Centre" @default.
- W3138115459 doi "https://doi.org/10.1016/j.jtho.2021.01.687" @default.
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