PD-L1 Testing for Lung Cancer in 2019: Perspective From the IASLC Pathology Committee

Sylvie Lantuejoul, Ming Sound-Tsao, Wendy A. Cooper, Nicolas Girard, Fred R. Hirsch, Anja C. Roden, Fernando Lopez-Rios, Deepali Jain, Teh Ying Chou, Noriko Motoi, Keith M. Kerr, Yasushi Yatabe, Elisabeth Brambilla, John Longshore, Mauro Papotti, Lynette M. Sholl, Erik Thunnissen, Natasha Rekhtman, Alain Borczuk, Lukas BubendorfYuko Minami, Mary Beth Beasley, Johan Botling, Gang Chen, Jin Haeng Chung, Sanja Dacic, David Hwang, Dongmei Lin, Andre Moreira, Andrew G. Nicholson, Masayuki Noguchi, Giuseppe Pelosi, Claudia Poleri, William Travis, Akihiko Yoshida, Jillian B. Daigneault, Ignacio I. Wistuba, Mari Mino-Kenudson

Research output: Contribution to journalReview articlepeer-review

60 Scopus citations


The recent development of immune checkpoint inhibitors (ICIs) has led to promising advances in the treatment of patients with NSCLC and SCLC with advanced or metastatic disease. Most ICIs target programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) axis with the aim of restoring antitumor immunity. Multiple clinical trials for ICIs have evaluated a predictive value of PD-L1 protein expression in tumor cells and tumor-infiltrating immune cells (ICs) by immunohistochemistry (IHC), for which different assays with specific IHC platforms were applied. Of those, some PD-L1 IHC assays have been validated for the prescription of the corresponding agent for first- or second-line treatment. However, not all laboratories are equipped with the dedicated platforms, and many laboratories have set up in-house or laboratory-developed tests that are more affordable than the generally expensive clinical trial–validated assays. Although PD-L1 IHC test is now deployed in most pathology laboratories, its appropriate implementation and interpretation are critical as a predictive biomarker and can be challenging owing to the multiple antibody clones and platforms or assays available and given the typically small size of samples provided. Because many articles have been published since the issue of the IASLC Atlas of PD-L1 Immunohistochemistry Testing in Lung Cancer, this review by the IASLC Pathology Committee provides updates on the indications of ICIs for lung cancer in 2019 and discusses important considerations on preanalytical, analytical, and postanalytical aspects of PD-L1 IHC testing, including specimen type, validation of assays, external quality assurance, and training.

Original languageEnglish (US)
Pages (from-to)499-519
Number of pages21
JournalJournal of Thoracic Oncology
Issue number4
StatePublished - Apr 2020


  • Immunohistochemistry
  • Immunotherapy
  • PD-L1
  • SCLC

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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