Will the need for programmed cell death 1 ligand 1 (PD-L1) testing affect the use of checkpoint inhibitors in non–small-cell lung cancer? No.
One of the most important advances in recent years has been the broad application of biomarker testing to guide targeted therapy in distinct subpopulations of patients with non–small-cell lung cancer (NSCLC), such as the use of epidermal growth factor receptor (EGFR) mutation testing to positively select patients for treatment with EGFR tyrosine kinase inhibitors. The use of biomarkers to guide targeted therapy is so well established that the American Society of Clinical Oncology even codified this in its “Top Five” list of suggestions to improve the quality of oncology care: “Do not use a targeted therapy intended for use against a specific genetic aberration unless a patient’s tumor cells have a specific biomarker that predicts an effective response to the targeted therapy.”1
Pennell NA. PD-L1 Testing and Lack of Benefit to Guide Treatment With Immune Checkpoint Inhibitors in Patients With Non–Small-Cell Lung Cancer. JAMA Oncol. 2016;2(5):569-570. doi:10.1001/jamaoncol.2016.0040