PD-L1 testing as a way of personalizing the treatment of non-small cell lung cancer

Abstract

Lung cancer is one of the main causes of death from malignant neoplasm all around the world. For the purpose of personalized treatment immunohistochemical determination of specific proteins (biomarkers) presence in tissues and biological fluids is needed. Today management of patients with lung cancer is directly associated with determination of genes mutations: EGFR, ALK, ROS1 and rate of PD-L1 receptors expression. Depending on the PD-L1 expression level blockers of these receptors can be used as the first, supportive and second / third line therapy. As the first line of therapy for patients with high expression level of PD-L1 (≥ 50 % TPS) Pemblizomab is recommended, while for patients with moderate levels (PD-L1 1 – 49% TPS) PD-L1 blockers can be used only as a second / third line of therapy. In numerous clinical trials efficiency and safety of Pemrolizumab, Nivolumab and Atezolizumab have been proved. Testing of Avelumab, Durvalumab, as well as combined drugs – Ipilimumab and Tremilimumb are still going on.