1. Recommendations issued on PD-L1, TMB testing.
- Author
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Rice, Sherrie
- Subjects
- *
SMALL cell lung cancer , *NON-small-cell lung carcinoma , *HEALTH care teams , *IMMUNE checkpoint proteins , *IMMUNE checkpoint inhibitors - Abstract
This article provides recommendations for PD-L1 and TMB testing in patients with advanced non-small cell lung cancer (NSCLC) to guide the selection of immune checkpoint inhibitor therapies. The recommendations emphasize the use of validated PD-L1 immunohistochemistry expression assays and other targetable genomic biomarker assays, as well as the validation of all specimen types and fixatives. The article also highlights the importance of considering other genomic biomarkers, such as EGFR mutations and ALK rearrangement, in addition to PD-L1 testing for optimal therapy selection. The challenges of sample selection and intra-tumor heterogeneity in PD-L1 expression are acknowledged. The article concludes by emphasizing the need for further studies to compare the predictive ability of different PD-L1 assays in clinical trials of checkpoint inhibitor therapies. Additionally, the article discusses the use of a semiquantitative approach for reporting tumor mutational burden (TMB) and raises concerns about the variability of TMB in different tumor types and within the same tumor type. The panel recommends against using TMB alone to select patients with advanced non-small cell lung cancer for immune checkpoint inhibitor therapy due to insufficient evidence. [Extracted from the article]
- Published
- 2024