Assuntos
Obstrução das Vias Respiratórias , Humanos , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/diagnóstico por imagem , Broncopatias/diagnóstico por imagem , Masculino , Neoplasias de Tecido Muscular/complicações , Neoplasias de Tecido Muscular/diagnóstico por imagem , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/diagnóstico por imagem , Feminino , Pessoa de Meia-IdadeRESUMO
PD-L1 is an established predictive immunohistochemical biomarker of response to immune checkpoint inhibitors. At present, PD-L1 is routinely assessed on biopsy samples of advanced gastroesophageal cancer patients before initiating first-line treatment. However, PD-L1 is still a suboptimal biomarker, due to changing cut-off values and scoring systems, interobserver and interlaboratory variability.This practical illustrated review discusses the range of staining patterns of PD-L1 and the potential pitfalls and challenges that can be encountered when evaluating PD-L1, focusing on gastric and gastroesophageal adenocarcinoma (G/GEA) and esophageal squamous cell carcinoma (ESCC).
Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Neoplasias Gástricas , Humanos , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Antígeno B7-H1 , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Biomarcadores TumoraisRESUMO
Immune-checkpoint inhibitors targeting the PD-1/PD-L1 axis have brought significant clinical benefit in many solid cancer types, including gastrointestinal malignancies. However, it has been estimated that only 20-40% of patients respond to treatment. The pattern of expression and potential predictive value of PD-L1 as an immunohistochemical biomarker has been extensively studied in gastrointestinal neoplasms. Until now, its predictive value has been demonstrated, and is currently in use only in upper gastrointestinal malignancies (gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma).In this Review, we describe the technical aspects and challenges related to PD-L1 immunohistochemical assays, the current role of PD-L1 as a biomarker in clinical practice and we outline the main studies and clinical trials analyzing the prognostic and predictive value of PD-L1 in gastrointestinal cancers.