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de Jong, Joep J; Stoop, Hans; Nieboer, Daan; Boormans, Joost L; van Leenders, Geert J L H

Concordance of PD‐L1 expression in matched urothelial bladder cancer specimens

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  • Media type: E-Article
  • Title: Concordance of PD‐L1 expression in matched urothelial bladder cancer specimens
  • Contributor: de Jong, Joep J; Stoop, Hans; Nieboer, Daan; Boormans, Joost L; van Leenders, Geert J L H
  • imprint: Wiley, 2018
  • Published in: Histopathology
  • Language: English
  • DOI: 10.1111/his.13710
  • ISSN: 1365-2559; 0309-0167
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Aims</jats:title><jats:p>Programmed death ligand 1 (<jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1) expression has predictive value for response to immune‐checkpoint inhibitor treatment in urothelial cancer patients. The consistency of <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 expression among different specimen types, however, is unknown. The aim of this study is to compare <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 expression in matched transurethral resections of the bladder (<jats:styled-content style="fixed-case">TURB</jats:styled-content>), cystectomy specimens and lymph node metastases of urothelial cancer patients.</jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p>We performed <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 (<jats:styled-content style="fixed-case">SP</jats:styled-content>142) immunohistochemistry on whole tissue slides of 115 urothelial carcinoma patients who had undergone <jats:styled-content style="fixed-case">TURB</jats:styled-content>, followed by radical cystectomy and/or pelvic lymph node dissection. The <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 assay was positive if <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 expression in immune cells occupied ≥5% of the tumour area. <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 was positive in 15 of 97 (15.5%) <jats:styled-content style="fixed-case">TURB</jats:styled-content>, 17 of 98 (17.3%) cystectomies and nine of 49 (18.4%) lymph node metastases. Agreement of <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 assay outcome between cystectomy and <jats:styled-content style="fixed-case">TURB</jats:styled-content> (kappa = 0.34; <jats:italic>P</jats:italic> = 0.002) and cystectomy and lymph node metastasis (kappa = 0.35; <jats:italic>P</jats:italic> = 0.034) was fair; there was no agreement between <jats:styled-content style="fixed-case">TURB</jats:styled-content> and lymph node metastasis (kappa = 0.045; <jats:italic>P </jats:italic>= 0.82). Discordance of <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 outcome in matched <jats:styled-content style="fixed-case">TURB</jats:styled-content> and cystectomy specimens occurred more frequently after neoadjuvant therapy (53.3% versus 25.4%; <jats:italic>P</jats:italic> = 0.03), and was not associated with other clinicopathological parameters.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Urothelial bladder cancer patients showed fair agreement of <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 assay outcome in cystectomies and matched <jats:styled-content style="fixed-case">TURB</jats:styled-content> or lymph node specimens. <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 expression was discordant more often after neoadjuvant therapy. Therefore, immune‐checkpoint inhibitor studies should take into account specimen type and neoadjuvant therapy in assessing the predictive value of <jats:styled-content style="fixed-case">PD</jats:styled-content>‐L1 expression.</jats:p></jats:sec>