Comparison of Programmed Cell Death Ligand 1Status between Core Needle Biopsy and Surgical Specimens of Triple-Negative Breast Cancer
- Author:
Hyungwook CHOI
1
;
Sung Gwe AHN
;
Soong Joon BAE
;
Jee Hung KIM
;
Na Lae EUN
;
Yangkyu LEE
;
Ji Hae NAHM
;
Joon JEONG
;
Yoon Jin CHA
Author Information
- Publication Type:Original Article
- From:Yonsei Medical Journal 2023;64(8):518-525
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Pembrolizumab is currently used to treat advanced triple-negative breast cancer (TNBC) and high-risk early TNBC with neoadjuvant chemotherapy (NAC). The tumor-infiltrating lymphocyte (TIL) level and programmed cell death ligand 1 (PDL1) status are predictors of response to NAC and immune checkpoint inhibitor treatment. We aimed to investigate whether the PD-L1 status in core needle biopsies (CNBs) could represent the whole tumor in TNBC.
Materials and Methods:A total of 49 patients diagnosed with TNBC who received upfront surgery without NAC between January 2018 and March 2021 were included. The PD-L1 expression (SP142 and 22C3 clones) and TIL were evaluated in paired CNBs and resected specimens. The concordance PD-L1 status and TIL levels between CNBs and resected specimens were analyzed.
Results:PD-L1 positivity was more frequently observed in resected specimens. The overall reliability of TIL level in the CNB was good [intraclass correlation coefficient (ICC)=0.847, p<0.001]. The agreements of PD-L1 status were good and fair, respectively (SP142, κ=0.503, p<0.001; 22C3, κ=0.380, p=0.010). As the core number of CNB increased, the reliability and agreement also improved, especially from five tumor cores (TIL, ICC=0.911, p<0.001; PD-L1 [22C3], κ=0.750, p=0.028). Regarding PD-L1 (SP142), no further improvement was observed with ≥5 tumor cores (κ=0.600, p=0.058).
Conclusion:CNBs with ≥5 tumor cores were sufficient to represent the TIL level and PD-L1 (22C3) status in TNBC.
