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PD-L1 expression by Tumor Proportion Score (TPS) and Combined Positive Score (CPS) are similar in non-small cell lung cancer (NSCLC)
  1. Pedro De Marchi1,2,
  2. Leticia Ferro Leal3,4,
  3. Vinicius Duval da Silva4,5,
  4. Eduardo Caetano Albino da Silva5,
  5. Vladmir Claudio Cordeiro de Lima6,
  6. Rui Manuel Reis3,7,8
  1. 1 Department of Medical Oncology, Barretos Cancer Hospital, Barretos, Brazil
  2. 2 Oncoclinicas - Lung Cancer Branch, Rio de Janeiro, Brazil
  3. 3 Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
  4. 4 Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Barretos, Brazil
  5. 5 Department of Pathology, Barretos Cancer Hospital, Barretos, Brazil
  6. 6 Department of Medical Oncology, ACCamargo Cancer Center, Sao Paulo, Brazil
  7. 7 Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
  8. 8 ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
  1. Correspondence to Dr Pedro De Marchi, Department of Medical Oncology, Barretos Cancer Hospital, Barretos, Brazil; pedrodemarchi{at}yahoo.com.br

Abstract

Background For non-small cell lung cancer (NSCLC) the most used method for analysing programmed cell death ligand 1 (PD-L1) expression is the Tumor Proportion Score (TPS). Nevertheless, for other tumour types, the Combined Positive Score (CPS) has been the method of choice.

Aim Evaluate and compare the predictive value of both CPS and TPS as predictors of immunotherapy response in NSCLC, and to evaluate the agreement intra-observer between both methods and inter-observer between two expert lung pathologists.

Methods 56 NSCLC patients who were treated with anti-programmed cell death 1 (PD-1)/PD-L1 therapy were included. Two pathologists evaluated all cases independently, considering the sample’s adequacy for analysis, and the PD-L1 expression by TPS and CPS.

Results The Kappa coefficient for adequacy was 0.82 (95% CI 0.67 to 0.97). There was a high agreement between TPS and CPS and a high agreement between pathologists concerning the two methods. The Kappa coefficient between TPS and CPS was 0.85 for both pathologists, and between pathologists was 0.94 and 0.93 for TPS and CPS, respectively.

Conclusions Both methods proved to be equally predictive of response to anti-PD-1/PD-L1 therapy. There was both a high intra-observer agreement between the two methods and a high inter-observer agreement between pathologists. This study suggests that CPS could also be used in a routine setting for immunotherapy decision in NSCLC.

  • lung neoplasms
  • immunohistochemistry
  • biomarkers
  • tumour

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • Handling editor Dhirendra Govender.

  • Contributors PDM: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Data curation, Roles/Writing – original draft, Writing – review & editing, Visualization, Project administration. LFL: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Data curation, Writing – review & editing, Visualization, Project administration. VDdS: Investigation, Resources, Writing – review & editing, Visualization. ECAdS: Investigation, Resources, Writing – review & editing, Visualization. VCCdL: Methodology, Formal analysis, Writing – review & editing, Visualization, Supervision. RMR: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Data curation, Writing – review & editing, Visualization, Supervision, Funding acquisition.

  • Funding This study was funded by the Public Ministry of Labor Campinas (Research, Prevention and Education of Occupational Cancer) and by Barretos Cancer Hospital internal funds.

  • Competing interests LFL is recipient of a Public Ministry of Labor Campinas Fellowship, and RMR is recipient of CNPq productivity fellowship.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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