Patient Selection for Anti-PD-1/PD-L1 Therapy in Advanced Non-Small-Cell Lung Cancer: Implications for Clinical Practice

Abstract

Immune checkpoint inhibitors targeting PD-1 or PD-L1 represent a standard treatment option for patients with advanced non-small-cell lung cancer. However, a substantial proportion of patients will not benefit from these treatments, and robust biomarkers are required to help clinicians select patients who are most likely to benefit. Here, we discuss the available evidence on the utility of clinical characteristics in the selection of patients with advanced non-small-cell lung cancer as potential candidates for single-agent anti-PD-1/PD-L1 therapy, and provide practical guidance to clinicians on identifying those patients who are most likely to benefit. Recommendations on the use of immune checkpoint inhibitor in clinically challenging populations are also provided.

<p>Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable <em>KRAS</em>-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review</p>

“…In the case we reported here, the patient had an unresectable HAL but achieved an overall survival of 52 months from multiple lines of treatment including chemotherapy and anti-PD1 therapy. 25 ICIs targeting PD-(L)1 represent a standard treatment option for patients with advanced NSCLC and have shown promising response in clinical treatment. 26 Positive PD-L1 expression, high tumor mutation burden and mismatch repair-deficient have been proposed as a potential predictor for response to ICI.…”

Association of PD-L1 Expression with Prognosis Among Patients with Ten Uncommon Advanced Cancers

“…Tumors with high levels of MSI (MSI-H) upregulate immune checkpoint proteins, including PD-L1, enabling evasion of immune surveillance [ 8 , 9 ]. As response to anti-PD-1 therapies can vary from patient to patient and between tumor types [ 10 ], predictive biomarkers may identify patients more likely to benefit from such therapies [ 11 ]. Tumor PD-L1 expression has been established as a biomarker for patient selection for monotherapy with the anti-PD-1 monoclonal antibody pembrolizumab in multiple tumor types including advanced non-small-cell lung cancer (NSCLC), melanoma, cervical cancer, gastric cancer, head and neck squamous cell cancer and esophageal cancer [ 2 , 12–18 ], and MSI-H has been established as a tumor-agnostic biomarker for pembrolizumab monotherapy [ 2 , 19–21 ].…”

Synchronous Occurrence of Bazex Syndrome and Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome in a Patient with Lung Cancer

“…Recently, ICIs have been widely used in cancer therapy, including lung cancer (16-18). However, ICIs are known to exacerbate preexisting autoimmune disease (19, 20). Paraneoplastic syndromes are treatable with cancer therapy.…”