High interobserver and intraobserver reproducibility among pathologists assessing PD-L1 CPS across multiple indications.

AIMS: A common concern among pathologists scoring PD-L1 immunohistochemical staining is interobserver and intraobserver variability. We assessed the interobserver and intraobserver reproducibility of PD-L1 scoring among trained pathologists using a combined positive score (CPS; tumour cell and tumour-associated immune cell staining). METHODS AND RESULTS: Data were collected for 2 years (2017-2019) from 456 pathologists worldwide. Digital training encompassed unique, tumour-specific training, and test sets. Samples were stained using PD-L1 IHC 22C3 pharmDx and evaluated at specific CPS cutoffs for gastric cancer (GC), cervical cancer (CC), urothelial cancer (UC), oesophageal cancer (OC), and head and neck squamous cell carcinoma (HNSCC). Pathologists underwent expert-to-peer training and scored 20 blinded samples on day 1 and 25 blinded samples on day 2 (including 15 of the day 1 samples). Interobserver and intraobserver reproducibility were assessed. For GC (120 observers) and CC (32 observers) samples assessed at CPS ≥1, average interobserver agreement was 91.5% and 91.0%, respectively, and average intraobserver agreement was 90.2% and 96.6%, respectively. For UC (139 observers) and OC (52 observers) samples measured at CPS ≥10, average interobserver agreement was 93.4% and 93.7%, respectively, and average intraobserver agreement was 92.0% and 92.5%, respectively. For HNSCC samples (113 observers), average interobserver agreement was 94.1% at CPS ≥1 and 86.5% at CPS ≥20; intraobserver agreement was 94.7% at CPS ≥1 and 90.5% at CPS ≥20. CONCLUSION: The consistently high interobserver and intraobserver concordance rates support the effectiveness of face-to-face training of many global pathologists for scoring PD-L1 CPS across multiple indications at several specific cutoffs.

Flexibility of Fluorinated Graphene-Based Materials.

The resistivity of different films and structures containing fluorinated graphene (FG) flakes and chemical vapor deposition (CVD)-grown graphene of various fluorination degrees under tensile and compressive strains due to bending deformations was studied. Graphene and multilayer graphene films grown by means of the chemical vapor deposition (CVD) method were transferred onto the flexible substrate by laminating and were subjected to fluorination. They demonstrated a weak fluorination degree (F/C lower 20%). Compressive strains led to a strong (one-two orders of magnitude) decrease in the resistivity in both cases, which was most likely connected with the formation of additional conductive paths through fluorinated graphene. Tensile strain up to 3% caused by the bending of both types of CVD-grown FG led to a constant value of the resistivity or to an irreversible increase in the resistivity under repeated strain cycles. FG films created from the suspension of the fluorinated graphene with a fluorination degree of 20-25%, after the exclusion of design details of the used structures, demonstrated a stable resistivity at least up to 2-3% of tensile and compressive strain. The scale of resistance changes R/R0 was found to be in the range of 14-28% with a different sign at the 10% tensile strain (bending radius 1 mm). In the case of the structures with the FG thin film printed on polyvinyl alcohol, a stable bipolar resistive switching was observed up to 6.5% of the tensile strain (bending radius was 2 mm). A further increase in strain (6.5-8%) leads to a decrease in ON/OFF current ratio from 5 down to 2 orders of magnitude. The current ratio decrease is connected with an increase under the tensile strain in distances between conductive agents (graphene islands and traps at the interface with polyvinyl alcohol) and thickness of fluorinated barriers within the active layer. The excellent performance of the crossbar memristor structures under tensile strain shows that the FG films and structures created from suspension are especially promising for flexible electronics.