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What?<\/strong><\/span><\/p>\n PD-L1 is a transmembrane protein expressed in cancer cells that down-regulates immune responses through binding to its two inhibitory receptors, PD-1 and B7.1. PD-1 and B7.1 are inhibitory receptors expressed on T cells following T-cell activation, sustained expression of these receptors are seen in states of chronic stimulation such as in chronic infection or cancer.<\/p>\n Ligation of PD-L1 present on the cancer cells with PD-1 on the T-cells inhibit their proliferation, leading to inactivation of T-cells.<\/p>\n Increase in the expression of PD-L1 on tumor cells has been reported to decrease the anti-tumor immunity, resulting in immune evasion. Therefore, interruption of the PD-L1\/PD-1 pathway represents an attractive therapeutic strategy in treatment of Non-small cell lung cancer<\/a><\/span> (NSCLC) and other tumors.<\/p>\n When?<\/span><\/strong><\/span><\/p>\n For patients with Metastatic (Stage IV NSCLC), NCCN developed an algorithm for initial therapy. Patients with EGFR, ALK, or ROS1 mutations or rearrangements at diagnosis, which collectively constitute about 25% of NSCLC, should receive targeted therapy as first-line treatment (category 1 recommendation). For patients with NSCLC whose tumors are positive for PD-L1 while being negative or unknown for other mutations or rearrangements in EGFR,\u00a0ALK\u00a0and ROS1 the drug Pembrolizumab is recommended as a first-line choice.<\/p>\n How?<\/strong><\/span><\/p>\n PD-L1 Testing in our laboratory is done by Ventana PD-L1 (SP263) Assay. This assay is CE (European Conformity) Labelled to inform treatment decisions in Lung Cancer Patients being considered for Pembrolizumab immunotherapy as a first line of treatment.<\/p>\n Recommended positive cut off for PDL-1 (Clone SP263) in Lung cancer (NSCLC) is : >1= 50% of tumor cells. Studies showed superior progression free survival and overall survival in first-line treatment of metastatic NSCLC with PDL-1 expression >\/= 50%.<\/p>\n Test Details:<\/strong>
\nTest Name:-<\/strong> IMMUNOHISTOCHEMISTRY<\/a><\/span>, PD-L1
\nSpecimen:-<\/strong> Submit tumour tissue in 10% formal-saline OR formalin fixed paraffin embedded block.
\nShip at room temperature. Provide a copy of the histopathology report. Indicate site of biopsy and provide clinical history.
\nMethod:-<\/strong> Immunohistochemistry
\nTAT:<\/strong> Sample Daily by 6 pm; Report : Blocks: 5 Days ; Tissues : 7 Days<\/p>\n