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<p>Immune checkpoint inhibitors targeting PD-1/PD-L1 are approved for metastatic non-small-cell lung cancer treatment. In clinical practice, the treatment choice depends on visual scoring of PD-L1, which is subjective and semi-quantitative. In this work, we present PD-L1 Quantitative Continuous Scoring (PD-L1 QCS), a computer vision system for granular cell-level quantification of PD-L1 staining intensity in digitized whole slide images (WSI). We derived a biomarker which captures the percentage of tumor cells (TC) with medium to strong staining intensity (PD-L1 QCS-PMSTC) and classifies patients with ≥0.575% as biomarker positive (BM+). Its effectiveness was examined against visual scoring of %TC ≥ 50 in 768 WSI from the MYSTIC trial (NCT02453282). Considering anti-PD-L1 treatment (N = 256) vs. chemotherapy (N = 246), visual scoring resulted in a hazard ratio (HR) of 0.69 (CI 0.46–1.02) with a 29.7% prevalence of the BM+ group. With PD-L1 QCS-PMSTC, a similar HR of 0.62 (CI 0.46–0.82) with an increased prevalence of 54.3% was obtained.</p>

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Enhanced patient selection with quantitative continuous scoring of PD-L1 expression for IO treatment in metastatic NSCLC

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月18日

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  • J. Lesniak,
  • M. Schick,
  • T. Kunzke,
  • F. Pollastri,
  • J. P. Vigueras-Guillén,
  • H. Hessel,
  • S. Haneder,
  • P. Sontakke,
  • K. DaCosta,
  • R. Alleze,
  • J. Zimmermann,
  • A. Kapil,
  • N. Brieu,
  • A. Shumilov,
  • H. Sade,
  • J. C. Barrett,
  • G. Schmidt,
  • R. Stewart

摘要

Immune checkpoint inhibitors targeting PD-1/PD-L1 are approved for metastatic non-small-cell lung cancer treatment. In clinical practice, the treatment choice depends on visual scoring of PD-L1, which is subjective and semi-quantitative. In this work, we present PD-L1 Quantitative Continuous Scoring (PD-L1 QCS), a computer vision system for granular cell-level quantification of PD-L1 staining intensity in digitized whole slide images (WSI). We derived a biomarker which captures the percentage of tumor cells (TC) with medium to strong staining intensity (PD-L1 QCS-PMSTC) and classifies patients with ≥0.575% as biomarker positive (BM+). Its effectiveness was examined against visual scoring of %TC ≥ 50 in 768 WSI from the MYSTIC trial (NCT02453282). Considering anti-PD-L1 treatment (N = 256) vs. chemotherapy (N = 246), visual scoring resulted in a hazard ratio (HR) of 0.69 (CI 0.46–1.02) with a 29.7% prevalence of the BM+ group. With PD-L1 QCS-PMSTC, a similar HR of 0.62 (CI 0.46–0.82) with an increased prevalence of 54.3% was obtained.