Clinical evaluation of a laboratory-developed test using clone E1L3N for the detection of PD-L1 expression status in non-small cell lung cancer

J Clin Lab Anal. 2021 Mar;35(3):e23696. doi: 10.1002/jcla.23696. Epub 2021 Jan 12.

Abstract

Background: Programmed death ligand 1 (PD-L1) has been used as a diagnostic marker to identify patients that will benefit from immune checkpoint inhibitors in non-small cell lung cancer (NSCLC). Immunohistochemistry with E1L3N clone is one of the most widely used and inexpensive laboratory-developed tests for PD-L1, but still need to be compared and validated with standard methods for clinical application.

Methods: We investigated the performance of E1L3N clone for PD-L1 testing in 299 tumor tissues of NSCLC patients and its comparability with FDA-approved 22C3 clone.

Results: The results show that the negative coincidence rate, weak positive coincidence rate, and positive coincidence rate were 97.4%, 92.2%, and 97.6% using the E1L3N assay relative to the 22C3 assay, respectively. An overall agreement of 96.3% was achieved between these two assays. We also found that the overall concordances were 97.8% and 93.9% for PD-L1 detection in large and small specimens, respectively, and no significant difference was obtained between these two assays (p = 0.076). In addition, the expression of PD-L1 was not detected in tumor tissues of benign lung disease using both the E1L3N and 22C3 assays.

Conclusion: E1L3N can be used as a reliable alternative antibody clone to evaluate PD-L1 expression status for NSCLC patients.

Keywords: E1L3N; PD-L1; consistency evaluation; immunotherapy; non-small cell lung cancer.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Antibodies
  • B7-H1 Antigen / analysis*
  • B7-H1 Antigen / immunology
  • B7-H1 Antigen / metabolism
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Non-Small-Cell Lung / metabolism*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Female
  • Humans
  • Immunohistochemistry / methods*
  • Lung Neoplasms / metabolism*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Antibodies
  • B7-H1 Antigen
  • Biomarkers, Tumor
  • CD274 protein, human