Immunohistochemical comparison of three programmed death-ligand 1 (PD-L1) assays in triple-negative breast cancer

• Published in: PloS one 2021-09, Vol.16 (9), p.e0257860-e0257860
• Main Authors: Yoshikawa, Katsuhiro, Ishida, Mitsuaki, Yanai, Hirotsugu, Tsuta, Koji, Sekimoto, Mitsugu, Sugie, Tomoharu
• Format: Article
• Language: English
• Subjects: Antibodies; Apoptosis; Assaying; Biology and Life Sciences; Breast cancer; Chemotherapy; Complications and side effects; Diagnosis; Evaluation; Genetic aspects; Immune system; Immunotherapy; Ligands; Lung cancer; Medical research; Medicine and Health Sciences; Mortality; Pathology; Patient outcomes; Patients; PD-L1 protein; Proteins; Research and Analysis Methods; Surgery; Tumor cells; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0257860

Background Triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. A recent study demonstrated the efficacy of anti-PD-L1 (anti-programmed death ligand-1) immunotherapy in patients with TNBC. However, the identification of TNBC patients who may benefit from immunotherapy is a critical issue. Several assays have been used to evaluate PD-L1 expression, and a few studies comparing PD-L1 expression using various primary antibodies in TNBC tissues have been reported. However, the expression profiles of the PD-L1 using the 73-10 assay have not yet been analyzed in TNBC tissues. Methods We analyzed the PD-L1 immunohistochemical profiles of 62 women with TNBC using the 73-10, SP142 (companion diagnostic for atezolizumab), and E1L3N assays. PD-L1 expression on immune cells (ICs) and tumor cells (TCs) was also evaluated, and PD-L1 positivity was defined as a PD-L1-expressing ICs or TCs [greater than or equal to] 1%. Results The expression rates of PD-L1 were 79.0%, 67.7%, and 46.8% on ICs, and 17.7%, 6.5%, and 12.9% on TCs using the 73-10, SP142, and E1L3N assays, respectively. The concordance rates between the 73-10 and SP142 assays were 85.5% (on ICs) and 88.7% (on TCs), respectively, and substantial agreement on ICs (coefficient 0.634) and moderate agreement (coefficient 0.485) on TCs were noted. Sample age and tumor diameter did not influence the ratio of PD-L1 expression among the assays. Conclusions The positive rate on ICs and TCs of the 73-10 assay was higher than that of the SP 142 and E1L3N assays. Although substantial agreement on ICs and moderate agreement on TCs between the 73-10 and SP142 assays was noted in the present cohort, further studies are needed to clarify the PD-L1 expression status using various primary antibodies in a larger patient population. This would lead to the establishment of an effective evaluation method to assess the predictive value of anti-PD-L1 immunotherapy.