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Beyond PD-L1 Markers for Lung Cancer Immunotherapy

Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-090 Lublin, Poland
Clinical Oncology Unit, Clinic of Clinical Oncology and Breast Diseases Polish Mother’s Memorial Hospital, Research Institute, 93-338 Łódź, Poland
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(8), 1915;
Received: 19 March 2019 / Revised: 7 April 2019 / Accepted: 15 April 2019 / Published: 18 April 2019
(This article belongs to the Special Issue PD-L1, A Master Regulator of Immunity)
Immunotherapy using immune checkpoints inhibitors has become the standard treatment for first and second line therapy in patients with non-small cell lung cancer (NSCLC). However, proper predictive factors allowing precise qualification of NSCLC patients for immunotherapy have not been developed so far. Expression of PD-L1 on tumor cells and tumor mutation burden are used in qualification of patients to first line therapy with pembrolizumab and atezolizumab in combination with ipilimumab in prospective clinical trials. Nevertheless, not all patients with these predictive factors benefit from immunotherapy. Major methodological difficulties in testing of these factors and in the interpretation of test results still exist. Therefore, other predictive factors are sought. Intensive research on the recognition of tumor immunophenotype and gut microbiome in NSCLC patients are underway. The first correlations between the effectiveness of immunotherapy and the intensity of inflammatory response in the tumor, microbiome diversity, and the occurrence of certain bacterial species in gut have been described. The purpose of our manuscript is to draw attention to factors affecting the efficacy of immunotherapy with anti-PD-L1 antibodies in NSCLC patients. Additional markers, for example TMB (tumor mutations burden) or microbiome profile, are needed to more accurately determine which patients will benefit from immunotherapy treatment. View Full-Text
Keywords: NSCLC; immune-check points inhibitors; PD-1; PD-L1; tumor mutation burden; tumor immunophenotype; microbiome NSCLC; immune-check points inhibitors; PD-1; PD-L1; tumor mutation burden; tumor immunophenotype; microbiome
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Wojas-Krawczyk, K.; Kalinka, E.; Grenda, A.; Krawczyk, P.; Milanowski, J. Beyond PD-L1 Markers for Lung Cancer Immunotherapy. Int. J. Mol. Sci. 2019, 20, 1915.

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