Programmed cell death ligand-1 (PD-L1) expression by immunohistochemistry: could it be predictive and/or prognostic in non-small cell lung cancer?
Programmed cell death ligand-1 (PD-L1) expression by immunohistochemistry: could it be predictive and/or prognostic in non-small cell lung cancer?
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DOI：
10.20892/j.issn.2095-3941.2016.0009
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发表时间：
2016-06
影响因子：
5.5
通讯作者：
Mino-Kenudson M
中科院分区：
文献类型：
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作者：
Mino-Kenudson M
最近，阻断免疫检查点已成为多种肿瘤的一种新的治疗策略。尤其是针对程序性细胞死亡1(PD-1)或其配体(PD-L1)的单抗在肺癌中的研究最多，PD-1抑制剂现已成为治疗非小细胞肺癌(NSCLC)的公认药物。高调临床试验的报道表明，免疫组织化学(IHC)检测PD-L1的表达与PD-1/PD-L1轴阻断的总体反应率较高有关，提示PD-L1的表达可能是一种预测标记物。然而，不幸的是，每个PD-1或PD-L1抑制剂都与特定的PD-L1抗体、IHC方案和用于生物标记物评估的评分系统相结合，使得这些研究难以进行面对面的比较。同样，将PD-L1的表达与临床病理和/或分子变量和/或生存期相关联的多个临床系列报告了相互矛盾的结果。这种差异可以通过研究中包括的种族和/或组织类型的差异来解释，但这似乎部分归因于PD-L1 IHC方法的差异。因此，有必要协调努力使PD-L1 IHC标准化，以建立IHC作为非小细胞肺癌预测和/或预后的生物标记物。
Blockade of immune checkpoints has recently emerged as a novel therapeutic strategy in various tumors. In particular, monoclonal antibodies targeting programmed cell death 1 (PD-1) or its ligand (PD-L1) have been most studied in lung cancer, and PD-1 inhibitors are now established agents in the management of non-small cell lung cancer (NSCLC). The reports on high-profile clinical trials have shown the association of PD-L1 expression by immunohistochemistry (IHC) with higher overall response rates to the PD-1/PD-L1 axis blockade suggesting that PD-L1 expression may serve as a predictive marker. Unfortunately, however, each PD-1 or PD-L1 inhibitor is coupled with a specific PD-L1 antibody, IHC protocol and scoring system for the biomarker assessment, making the head-to-head comparison of the studies difficult. Similarly, multiple clinical series that correlated PD-L1 expression with clinicopathologic and/or molecular variables and/or survival have reported conflicting results. The discrepancy could be explained by the differences in ethnicity and/or histologic types included in the studies, but it appears to be attributed in part to the differences in PD-L1 IHC methods. Thus, orchestrated efforts to standardize the PD-L1 IHC are warranted to establish the IHC as a predictive and/or prognostic biomarker in NSCLC.