Challenges of PD-L1 testing in non-small cell lung cancer and beyond
Minyu Wang, Sen Wang, Joseph A. Trapani, Paul J. Neeson
Abstract
Treatment options and clinical outcomes for non-small cell lung cancer (NSCLC) have recently been transformed with the introduction of immune checkpoint blockade (ICB), including antibodies targeting programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1). In advanced NSCLC patients with no epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genomic tumour aberrations, anti-PD-1/PD-L1 given either as a monotherapy or combined with chemotherapy had superior efficacy over standard chemotherapy (1). Accordingly, nivolumab (OPDIVO, Bristol-Myers Squibb) (2); pembrolizumab (KEYTRUDA, Merck Sharp & Dohme) (3); atezolizumab (TECENTRIQ, Roche/ Genentech) (4); and durvalumab (IMFINZI, MedImmune/ AstraZeneca) (5) have achieved regulatory approval for advanced NSCLC (Table These agents are expensive and have side effects that may lead to life-threatening toxicity.