Schoemig-Markiefka, Birgid, Eschbach, Jana, Scheel, Andreas H., Pamuk, Aylin, Rueschoff, Josef, Zander, Thomas, Buettner, Reinhard, Schroeder, Wolfgang, Bruns, Christiane J., Loeser, Heike, Alakus, Hakan and Quaas, Alexander (2021). Optimized PD-L1 scoring of gastric cancer. Gastric Cancer, 24 (5). S. 1115 - 1123. NEW YORK: SPRINGER. ISSN 1436-3305

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Abstract

Background PD-1/PD-L1-Immunotherapy has been approved for gastric carcinoma. PD-L1 assessment by immunohistochemistry is the principle biomarker. Are biopsies able to map the actual PD-L1 status of the entire tumor? Methods Whole tumor slides of 56 gastric carcinoma were analyzed to determine the distribution of PD-L1 positive cells in the entire tumor areas. Tissue micro arrays with four cores of the tumor surface, which represents the endoscopically accessible biopsy zone, were built from the same tumors. The PD-L1 CPS value was determined separately for each core. Preoperative diagnostic biopsies were available for 22 of the tumors. PD-L1 prevalence, sensitivity and specificity were analyzed using the whole tumor slides as reference scores. Molecular subtyping was performed and related to the PD-L1 status. Results 27.3% of cases were PD-L1 negative (CPS < 1), 43.6% showed low PD-L1 expression (CPS >= 1 to < 5), 12.7% moderate (CPS >= 5 to < 10) and 16.4% strong expression (CPS >= 10). The biopsies showed best test characteristics if four surface biopsies were analyzed combined, i.e., the CPS was calculated across all four biopsies. The prevalence showed a distribution similar to the resection specimens, sensitivity was 0.73 and specificity 1.0. Using fewer surface biopsies decreased sensitivity and specificity and caused false-negative classifications. Compared to the TMAs, the preoperative biopsies showed reduced sensitivity (0.412). Conclusions This is the first comprehensive study to optimize PD-L1 assessment in gastric cancer using endoscopically available tissue. The obtained PD-L1 prevalence is consistent with data of current clinical studies. Calculation of the test characteristics shows that surface biopsies can be indicative of the true PD-L1 status based on the resection specimen. However, an adequate number of biopsies is required. In this study, n = 4 biopsies yielded best results.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schoemig-Markiefka, BirgidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eschbach, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheel, Andreas H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pamuk, AylinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rueschoff, JosefUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zander, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buettner, ReinhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroeder, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruns, Christiane J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loeser, HeikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alakus, HakanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Quaas, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-578635
DOI: 10.1007/s10120-021-01195-4
Journal or Publication Title: Gastric Cancer
Volume: 24
Number: 5
Page Range: S. 1115 - 1123
Date: 2021
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1436-3305
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TUMOR; EXPRESSIONMultiple languages
Oncology; Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/57863

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