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Journal of Cancer Research and Clinical Oncology

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01-10-2019 | NSCLC | Original Article – Cancer Research

Validity of using immunohistochemistry to predict treatment outcome in patients with non-small cell lung cancer not otherwise specified

Authors: Takahiro Ota, Keisuke Kirita, Reiko Matsuzawa, Hibiki Udagawa, Shingo Matsumoto, Kiyotaka Yoh, Seiji Niho, Genichiro Ishii, Koichi Goto

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2019

Abstract

Purpose

Histology samples are important for the appropriate administration of tumor type-specific cytotoxic and molecular-targeted therapies for the treatment of non-small cell lung cancer (NSCLC). When biopsy samples lack a definite morphology, a diagnosis can be selected from three subtypes based on immunohistochemistry (IHC) results, as follows: favor adenocarcinoma (ADC), favor squamous cell carcinoma (SQC), or not otherwise specified (NOS)-null. In terms of patient outcome, however, the validity of IHC-based classifications remains unknown.

Methods

A large series of 152 patients with advanced NSCLC whose diagnoses had been made based on morphological findings and who had been homogeneously treated were enrolled. We used IHC staining (TTF-1, SP-A, p40, and CK5/6) to examine tumor samples and refined the diagnoses. We then analyzed the pathological subgroups according to the IHC staining results.

Results

IHC profiling resulted in 50% of the cases being classified as favor ADC, 31% being classified as favor SQC, and 19% being classified as NOS-null groups. Compared with the favor ADC and favor SQC groups, the NOS-null group had a significantly poorer outcome. Pemetrexed-containing platinum regimens produced a response rate similar to that of other platinum doublet regimens in the favor ADC group (44% vs. 46%), whereas it produced a poorer response in the favor SQC group (0% vs. 52%) and the NOS-null group (0% vs. 24%). The favor ADC group tended to have a higher percentage of EGFR positivity and ALK positivity than the favor SQC group (25% vs. 11% and 7% vs. 0%, respectively).

Conclusions

These findings support the use of immunohistological subtyping of NSCLC biopsy specimens to select patient-appropriate treatments.

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Title: Validity of using immunohistochemistry to predict treatment outcome in patients with non-small cell lung cancer not otherwise specified
Authors: Takahiro Ota
Keisuke Kirita
Reiko Matsuzawa
Hibiki Udagawa
Shingo Matsumoto
Kiyotaka Yoh
Seiji Niho
Genichiro Ishii
Koichi Goto
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
NSCLC
Published in: Journal of Cancer Research and Clinical Oncology / Issue 10/2019
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-019-03012-z

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Validity of using immunohistochemistry to predict treatment outcome in patients with non-small cell lung cancer not otherwise specified

Abstract

Purpose

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Results

Conclusions

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