All in the Levels-Programmed Death-Ligand 1 Expression as a Biomarker for Immune Checkpoint Inhibitor Response in Patients with Gastrointestinal Cancer
| Autor: | Sarah K Cimino, Kristen K. Ciombor, Satya Das, Shemeka Davis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Immune checkpoint inhibitors Pembrolizumab B7-H1 Antigen 03 medical and health sciences 0302 clinical medicine Immune system Text mining Stomach Neoplasms Internal medicine medicine Biomarkers Tumor Humans Gastrointestinal cancer Immune Checkpoint Inhibitors business.industry Cancer Ligand (biochemistry) medicine.disease 030104 developmental biology 030220 oncology & carcinogenesis Biomarker (medicine) business Brief Communications |
| Zdroj: | Oncologist |
| ISSN: | 1549-490X |
| Popis: | Immune checkpoint inhibitors (ICIs) benefit rare subsets of gastrointestinal (GI) cancer patients. Significant interest exists to identify predictive biomarkers which may increase the applicability of ICI therapy for these patients. Programmed-death ligand 1 (PD-L1) is one such candidate; however, this biomarker has well-chronicled limitations. Combined positive score (CPS) ≥ 1 is the minimum PD-L1 expression threshold necessary for gastric/gastroesophageal junction (GEJ) cancer patients to qualify for treatment with pembrolizumab; however, studies suggest that patients with higher CPS scores may derive greater benefit. We present the cases of two patients, both with low tumor mutational burden, microsatellite stable and CPS ≥ 70 GI tumors (cholangiocarcinoma and GEJ cancer), who have achieved excellent tumor control with pembrolizumab. We postulate that by testing for CPS in all GI cancer patients, and identifying a CPS threshold predictive of ICI response, PD-L1 expression could identify the GI cancer patients, in tissue agnostic fashion, who could benefit from ICI therapy. IMPLICATIONS FOR PRACTICE: CPS measures PD-L1 expression on both tumor and immune cells and has been used to select advanced cancer patients for pembrolizumab therapy. A CPS ≥ 1, however, carries limited predictive capacity to identify the patients who may derive benefit from the immune checkpoint inhibitor (ICI). The two patient cases presented suggest that that perhaps by testing CPS in all gastrointestinal (GI) cancer patients, beyond those with gastric/gastroesophageal cancer, and defining an appropriate CPS threshold, PD-L1 expression may better predict ICI benefit for GI cancer patients irrespective of tumor type. Further studies are needed to verify this hypothesis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text