PD-L1 biomarker testing for non-small cell lung cancer: truth or fiction?

Grigg, Claud; Rizvi, Naiyer A.

doi:10.1186/s40425-016-0153-x

Cited by 195 publications

(149 citation statements)

References 69 publications

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“…This biomarker offers some prognostic information for patients beginning treatment with nivolumab or pembrolizumab, but cannot predict non-benefiting patients [5]. This is demonstrated by the results of the CheckMate 057 trial, in which although PD-L1 expression was shown to correlate with prolonged survival vs docetaxel in non-squamous cell NSCLS, durable responses were observed in patients with no PD-L1 expression [2].…”

Section: Introductionmentioning

confidence: 76%

Prognostic and Predictive Value of Pretreatment Derived Neutrophil-to-Lymphocyte Ratio in Non-Small-Cell Lung Cancer Patients Treated with an Immune Checkpoint Inhibitor

Kucharczyk¹,

Sullivan²,

Lu³

et al. 2018

JCT

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Background: Immune checkpoint inhibitors produce prolonged responses in select non-small cell lung cancer (NSCLC) patients, however the identification of patients most likely to benefit is difficult. Pretreatment derived neutrophil-to-lymphocyte ratio (dNLR) is an easily calculated marker available in routine clinical care that has shown prognostic value in many cancer treatment settings, but its association with survival in NSCLC patients treated with immune-checkpoint inhibitors is less understood. Patients and Methods: We retrospectively reviewed 72 NSCLC patients receiving either nivolumab or pembrolizumab between 3/1/15 and 3/1/17 with a median follow-up time of 5.1 months. Patients were compared using Cox proportional hazards models to detect an association between pretreatment dNLR < 3 vs ≥3 on overall survival (OS), progression-free survival (PFS) and overall response rate. Results: Median age was 65 (range: 41 -86), 65% were male, 40% received ≥

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Section: Introductionmentioning

confidence: 76%

Prognostic and Predictive Value of Pretreatment Derived Neutrophil-to-Lymphocyte Ratio in Non-Small-Cell Lung Cancer Patients Treated with an Immune Checkpoint Inhibitor

Kucharczyk¹,

Sullivan²,

Lu³

et al. 2018

JCT

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“…PD-L1 expression is a dynamic rather than static process that varies according to different tumor and host factors (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Several data show that anti-PD-L1 drugs are more effective in patients whose tumors express PD-L1, but responses in the population of patients without the expression lead to the conclusion that these patients also benefit from this treatment.…”

Section: The Problems Of Pd-l1 As a Biomarkermentioning

confidence: 99%

“…Currently, two checkpoint inhibitors (PD-L1 inhibitors) pembrolizumab and nivolumab are being used in everyday clinical practice, but it is supposed that soon others such as atezolizumab, durvalumab, and avalumab will enter into everyday clinical use [24]. Quick development of new immunotherapeutic drugs is not followed by proper development in optimal biomarkers for patient selection.…”

Section: Immune Checkpoint Inhibitors In Lung Cancer and Pd-l1 As Prementioning

confidence: 99%

Prognostic and Predictive Value of PD-L1 in Patients with Lung Cancer

Rajer¹

2017

A Global Scientific Vision - Prevention, Diagnosis, and Treatment of Lung Cancer

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Improved understanding of the molecular mechanisms has led to identification of checkpoint signalling and development of checkpoint inhibitors in the treatment of many cancers, including lung cancer. To be able to select the patients who benefit most from checkpoint inhibitors, predictive biomarkers are needed. Currently, the only predictive biomarker that has been approved in clinical use is PD-L1, the ligand of the inhibitory T-cell checkpoint PD-1. The use of PD-L1 as a predictive biomarker is confounded by multiple unresolved issues, from testing issues (e.g., cut-off values for positivity) to clinical use (e.g., the response to anti-PD-1 and anti-PD-L1 antibodies in patients without any expression of PD-L1). Even more open questions exist in the evaluation of PD-L1 as a prognostic biomarker. In the future, we expect that an improved understanding of immune system, tumor microenvironment, mechanism of action of immunotherapeutic drugs, and PD-L1 testing methods will elucidate the value of PD-L1 as a prognostic and predictive biomarker in detail.

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“…Cytology samples are currently not recommended for PD‐L1 testing as these samples were excluded from the clinical trials evaluating immunotherapeutic agents, and there is concern about the technical performance of PD‐L1 IHC assays when different fixatives are used, such as alcohol‐based fixatives that are often used for cytological cell block preparations 1, 2. However, for some patients with advanced‐stage NSCLC, cytology samples are the only specimens available 3.…”

Section: Introductionmentioning

confidence: 99%

The novel 19G endobronchial USS (EBUS) needle samples processed as tissue “core biopsies” facilitate PD‐L1 and other biomarker testing in lung cancer specimens: case report and the view point from the Respiratory Physician and the Pathologist

Herath

Cooper

2017

Respirology Case Reports

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The immunohistochemical expression of Programmed Death Ligand (PD‐L1) predicts responses to PD‐1/PD‐L1 inhibitors in non‐small cell lung cancer (NSCLC). PD‐L1 testing is currently only recommended on tissue specimens; however, in many patients, cytology samples are the only specimens available. The introduction of the novel 19G “core‐biopsy” needle has revolutionized the utility of endobronchial USS‐guided biopsy (EBUS) by providing solid tissue “microbiopsies” rather than traditional liquid cytology samples. We report a case of metastatic adenocarcinoma with the only accessible site of biopsy being a hilar lymph node. Using the 19G core‐biopsy needle and processing the microbiopsy samples in formalin provided more material for predictive biomarker testing, including PD‐L1 immunohistochemistry, when traditional processing was inadequate. This case highlights the need for close multidisciplinary discussions between the pathologist and the respiratory physician regarding emerging biomarkers and novel biopsy techniques to obtain maximum utility of the tools and avoid repeated procedures for the patient.

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PD-L1 biomarker testing for non-small cell lung cancer: truth or fiction?

Cited by 195 publications

References 69 publications

Prognostic and Predictive Value of Pretreatment Derived Neutrophil-to-Lymphocyte Ratio in Non-Small-Cell Lung Cancer Patients Treated with an Immune Checkpoint Inhibitor

Prognostic and Predictive Value of Pretreatment Derived Neutrophil-to-Lymphocyte Ratio in Non-Small-Cell Lung Cancer Patients Treated with an Immune Checkpoint Inhibitor

Prognostic and Predictive Value of PD-L1 in Patients with Lung Cancer

The novel 19G endobronchial USS (EBUS) needle samples processed as tissue “core biopsies” facilitate PD‐L1 and other biomarker testing in lung cancer specimens: case report and the view point from the Respiratory Physician and the Pathologist

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