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We recently hosted a webinar called “Optimizing NSCLC Treatment with Biomarker Testing Insights”, featuring Dr. Jessica Lin of Mass General Cancer Center. In it, Dr. Lin discussed how biomarker testing identifies genetic mutations and resistance mechanisms in non-small cell lung treatment, informs better treatment decisions, and influences patient care. Listen to the replay and learn about the latest advancements that are transforming NSCLC treatment and driving improved patient outcomes.
**A summary of the discussion is below**
Immunotherapy has become a vital part of lung cancer treatment, specifically for patients whose tumors express high levels of the protein PD-L1. This protein is a critical marker in determining the potential effectiveness of immunotherapy, a treatment designed to stimulate the body’s immune response against cancer cells.
What is PD-L1?
PD-L1 (programmed death-ligand 1) is a protein expressed on some lung cancer tumor cells. When PD-L1 is present in high amounts—typically if it is expressed in over 50% of tumor cells—it indicates a higher likelihood that immunotherapy could be effective. The presence of PD-L1 allows the immune system to recognize and attack cancer cells more effectively when immunotherapy drugs are used.
Types of Cancer Treatments: Chemotherapy, Targeted Therapy, and Immunotherapy
There are three primary treatment approaches for lung cancer:
- Chemotherapy: The oldest form of treatment, which kills rapidly dividing cancer cells.
- Targeted Therapy: Designed for specific genetic mutations in cancer cells, aligning treatment with unique molecular profiles.
- Immunotherapy: Boosts the body’s immune system to fight cancer, especially effective in cases where PD-L1 expression is high.
Immunotherapy typically involves intravenous administration and has a distinct side-effect profile from chemotherapy. By enabling the immune system to identify cancer cells as foreign, immunotherapy aims to help the body mount a natural defense against cancer.
PD-L1 Testing and Treatment Decisions
Testing for PD-L1 is essential for personalizing treatment. For patients whose tumors express high levels of PD-L1 (above 50%), immunotherapy alone may be an effective initial treatment. In these cases, drugs such as pembrolizumab, nivolumab, and atezolizumab—known as immune checkpoint inhibitors—are commonly used.
However, for patients with low or absent PD-L1 expression, immunotherapy alone may be less effective. In such cases, doctors often recommend combining immunotherapy with chemotherapy to enhance treatment efficacy, as this combination can lead to a more robust response.
Benefits of a Personalized Approach in Lung Cancer Care
Personalized treatment based on PD-L1 levels and other biomarkers leads to more effective care, allowing patients to receive treatments specifically tailored to the biology of their tumors. This approach not only improves outcomes but also helps to minimize side effects by targeting therapies where they are most likely to be effective. For patients, this means a more hopeful and targeted path forward in lung cancer treatment.
In conclusion, understanding PD-L1 and its implications in immunotherapy has transformed lung cancer treatment. By identifying biomarkers, doctors can now provide more effective and personalized care, opening the door to better outcomes and a higher quality of life for those affected by lung cancer.
