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Predictive diagnostics for I-O

Presented By
Dr Enriqueta Felip, Vall d’Hebron University Hospital, Spain
ELCC 2019
Phase 3, BFAST
In the final lecture of the session, Dr Enriqueta Felip (Vall d’Hebron University Hospital, Spain) discussed predictive biomarkers for immunotherapy in stage 4 NSCLC. The most extensively studied predictive diagnostics include PD-L1 immunohistochemistry, tumour inflammation including RNA immune signatures and tumour-infiltrating lymphocytes (TILs), tumour mutational burden (TMB), and oncogenic alterations like KRAS, STK11/LKB1, and EGFR. PD-L1 expression is a biological continuum, so it is difficult to determine specific cut-off values. The magnitude of the benefit correlates with PD-L1 expression in the second-line treatment of NSCLC. However, some PD-L1-negative patients do respond to immunotherapy [1]. Next, a growing body of evidence suggests that TMB is predictive of immunotherapy efficacy in NSCLC. However, there are multiple relevant challenges, such as the methodology, standardisation, definition of high vs low TMB, clini...

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