Tumor mutational burden assessment as a predictive biomarker for immunotherapy in lung cancer patients: getting ready for prime-time or not?

摘要: The emergence of immunotherapy as a first- or second-line treatment has revolutionized the therapeutic management lung cancer patients. However, not all patients receive same benefit from this treatment, leading to limitations in number who can anti-PD-1/PD-L1 checkpoint inhibitors because some secondary toxicity been associated with immunotherapy, and would more chemotherapy. In context, selection is currently based on PD-L1 immunohistochemistry (IHC), specifically percentage positive tumor cells. To date, only validated biomarker that used companion diagnostic test for non-small cell carcinoma (NSCLC) sufficiently robust demonstrates many challenges. For example, than 50% cells are non-responders while conversely, other no good responders. mutation burden (TMB) load (TML) emerged recently new predictive response NSCLC. needs be routine clinical use shares similar constraints IHC biomarker. TMB two best biomarkers could soon systematically inform decisions advanced metastatic NSCLC aim review consider possible integration testing daily practice through pros- cons-debate, establish sample quality-dependent algorithms main current laboratories considering assessments.