New Test Can Identify NSCLC Patients Most Likely to Benefit from Immunotherapy

This article originally appeared on The American Journal of Managed Care.

A blood-based test to assess tumor mutational burden (TMB) was recently discovered as being able to accurately identify patients with non—small cell lung cancer (NSCLC) who could benefit from checkpoint inhibitor treatment. The study, conducted by researchers at UC Davis, Genentech, and Foundation Medicine, was published in Nature Medicine.

Checkpoint inhibitors have been found to be more effective in patients who exhibit certain biomarkers, such as the PD-L1 protein. More recently, it was recognized that patients who have a higher TMB, or number of mutations found in specific genomic sequences in tumor cells, often are better immunotherapy candidates.

“We wanted to know if we could transfer this TMB assay from tissue to blood,” David Gandara, MD, director of the Thoracic Oncology Program at the UC Davis Comprehensive Cancer Center, said in a statement. “We succeeded, establishing a TMB level in blood that correlates well with similar levels in tissue and was associated with favorable patient outcomes.”

Initial laboratory research methods to identify these biomarkers, such as exome sequencing, are time consuming and not always scalable for clinical care. Additionally, as many as 30% of patients with NSCLC have too little tumor tissue to facilitate these tests. The ability to use a blood test to identify relevant biomarkers is a much less invasive alternative than the traditional tissue testing.

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