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Comparison of Programmed Cell Death Ligand 1 Status between Core Needle Biopsy and Surgical Specimens of Triple-Negative Breast Cancer

 Hyungwook Choi  ;  Sung Gwe Ahn  ;  Soong Joon Bae  ;  Jee Hung Kim  ;  Na Lae Eun  ;  Yangkyu Lee  ;  Ji Hae Nahm  ;  Joon Jeong  ;  Yoon Jin Cha 
 YONSEI MEDICAL JOURNAL, Vol.64(8) : 518-525, 2023-08 
Journal Title
Issue Date
Apoptosis ; B7-H1 Antigen ; Biopsy, Large-Core Needle ; Humans ; Ligands ; Reproducibility of Results ; Triple Negative Breast Neoplasms*
PD-L1 ; Triple-negative breast cancer ; immunohistochemistry ; pathology ; tumor-infiltrating lymphocytes
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 (PD-L1) 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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jee Hung(김지형) ORCID logo https://orcid.org/0000-0002-9044-8540
Nahm, Ji Hae(남지해) ORCID logo https://orcid.org/0000-0003-0902-866X
Bae, Soong June(배숭준) ORCID logo https://orcid.org/0000-0002-0012-9694
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Eun, Na Lae(은나래) ORCID logo https://orcid.org/0000-0002-7299-3051
Lee, Yangkyu(이양규)
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
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