Precision medicine for NSCLC in the era of immunotherapy: New biomarkers to select the most suitable treatment or the most suitable patient

Giovanni Rossi, Alessandro Russo, Marco Tagliamento, Alessandro Tuzi, Olga Nigro, Giacomo Vallome, Claudio Sini, Massimiliano Grassi, Maria Giovanna Dal Bello, Simona Coco, Luca Longo, Lodovica Zullo, Enrica Teresa Tanda, Chiara Dellepiane, Paolo Pronzato, Carlo Genova

Research output: Contribution to journalReview articlepeer-review

Abstract

In recent years, the evolution of treatments has made it possible to significantly improve the outcomes of patients with non-small cell lung cancer (NSCLC). In particular, while molecular targeted therapies are effective in specific patient sub-groups, immune checkpoint inhibitors (ICIs) have greatly influenced the outcomes of a large proportion of NSCLC patients. While nivolumab activity was initially assessed irrespective of predictive biomarkers, subsequent pivotal studies involving other PD-1/PD-L1 inhibitors in pre-treated advanced NSCLC (atezolizumab within the OAK study and pembrolizumab in the Keynote 010 study) reported the first correlations between clinical outcomes and PD-L1 expression. However, PD-L1 could not be sufficient on its own to select patients who may benefit from immunotherapy. Many studies have tried to discover more precise markers that are derived from tumor tissue or from peripheral blood. This review aims to analyze any characteristics of the immunogram that could be used as a predictive biomarker for response to ICIs. Furthermore, we describe the most important genetic alteration that might predict the activity of immunotherapy.

Original languageEnglish
Article number1125
JournalCancers
Volume12
Issue number5
DOIs
Publication statusPublished - May 2020

Keywords

  • Biomarker
  • Immune checkpoint inhibitor
  • NSCLC
  • PD-L1
  • POLE
  • PTEN inactivation
  • STK11
  • T-Cell clonality
  • Tumor mutational burden

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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