BACKGROUND Immunotherapy has revolutionized the approach to metastatic triple-negative breast cancers. Atezolizumab was approved for patients with metastatic triple-negative breast cancers whose tumors express PD-L1, determined by SP 142 assay. To assess the availability and practice of SP142 test we administered a survey to all the 15 pathology departments of the Lazio Region during a six-month period. METHODS The survey comprised 12 questions regarding the availability of SP142 in the pathology departments, the percentage of positive tests, the difficulties of pathologists in cases close to cut-off value and the tested samples. RESULTS The SP142 assay was available in only eight centers. In case of positive result, most centers (5/8, 62.5%) reported values of PD-L1 expression ranging from > 1 to ⩽ 5%, with values close to the cut-off point (⩾ 1% or < 1%) being the greatest challenge.Most of the centers (6/8, 75%) tested material from both their own and other hospitals. In most centers, the evaluations were performed either on primary tumors or metastasis, in particular lymph nodes (5/8, 62.5%), followed by lung (3/8, 37.5%) and liver (1/8, 12.5%) metastasis. CONCLUSION Our results raise some important issues concerning the evaluation of PD-L1 in the "real-life" setting, providing strategies for its implementation.

中文翻译：

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转移性三阴性乳腺癌的 PD-L1 检测：意大利一项调查的结果。

背景技术免疫疗法彻底改变了转移性三阴性乳腺癌的治疗方法。Atezolizumab 被批准用于治疗转移性三阴性乳腺癌患者，其肿瘤通过 SP 142 测定确定表达 PD-L1。为了评估 SP142 检测的可用性和实践，我们在六个月的时间内对拉齐奥地区的所有 15 个病理科进行了一项调查。方法调查包括12个问题，涉及病理科SP142的可用性、阳性检测的百分比、病理学家在接近临界值的病例中的困难以及检测的样本。结果 SP142 检测仅在八个中心可用。如果出现阳性结果，大多数中心（5/8，62.5%）报告的 PD-L1 表达值范围为 > 1 至 ⩽ 5%，值接近截止点（⩾ 1% 或 < 1%）是最大的挑战。大多数中心（6/8，75%）测试了来自自己医院和其他医院的材料。在大多数中心，评估是针对原发肿瘤或转移瘤进行的，特别是淋巴结（5/8，62.5％），其次是肺（3/8，37.5％）和肝（1/8，12.5％）转移。结论 我们的结果提出了有关在“现实生活”环境中评估 PD-L1 的一些重要问题，并为其实施提供了策略。