a Medical Oncology , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy.
b Department of Diagnostics and Public Health , University of Verona , Verona , Italy.
Expert Rev Mol Diagn. 2017 Dec;17(12):1055-1069. doi: 10.1080/14737159.2017.1393333. Epub 2017 Oct 23.
In non-small-cell lung cancer (NSCLC) the recent introduction of immunotherapy in daily clinical practice produced a wave of enthusiasm, however, this was rapidly moderated by the evidence that only some patients could experience a relevant clinical benefit. Therefore, a great effort from the scientific community has been dedicated to the identification and validation of reliable biomarkers able to drive the activity of immunotherapeutic agents. Areas covered: This analysis aims to review the main findings about predictive biomarkers for immunotherapy in lung cancer, retracing the history of PD-L1 and focusing on a series of innovative candidates, such as mutational load, immune cell populations and microbiome. Expert commentary: Considering the complexity of the immune system-cancer interactions, the idea of identifying a single biomarker able to drive the activity of different immunotherapeutic agents alone, borrowing the idea of targeted therapy, is likely to represent an unrealistic objective. Nevertheless, the identification of those factors either positively or negatively affecting the response is mandatory in order to recruit the appropriate patients, but also to deeply understand the mechanisms of immune response and improve the clinical benefit deriving from these agents in monotherapy or in a biologically-rationale combination.
在非小细胞肺癌 (NSCLC) 中，免疫疗法最近在日常临床实践中的引入引发了一波热潮，但这很快被以下证据所缓和，即只有部分患者可以从中获得显著的临床获益。因此，科学界付出了巨大的努力来鉴定和验证可靠的生物标志物，以驱动免疫治疗药物的疗效。
本分析旨在回顾肺癌免疫治疗的预测性生物标志物的主要发现，追溯 PD-L1 的历史，并重点关注一系列创新的候选标志物，如突变负荷、免疫细胞群体和微生物组。
考虑到免疫系统与癌症相互作用的复杂性，单独鉴定一种能够驱动不同免疫治疗药物活性的单一生物标志物的想法，借鉴靶向治疗的理念，可能不太现实。然而，鉴定那些正向或负向影响免疫反应的因素是必需的，这样可以招募到合适的患者，还可以深入了解免疫反应的机制，并提高这些药物在单药治疗或基于生物学原理的联合治疗中的临床获益。
