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预测免疫检查点抑制剂治疗肺癌反应的生物标志物:PD-L1 及其他。

Predictive biomarkers for response to immune checkpoint inhibitors in lung cancer: PD-L1 and beyond.

机构信息

Department of Pathology, Toranomon Hospital, Tokyo, Japan.

Department of Pathology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Warren 122, Boston, MA, 02114, USA.

出版信息

Virchows Arch. 2021 Jan;478(1):31-44. doi: 10.1007/s00428-021-03030-8. Epub 2021 Jan 24.


DOI:10.1007/s00428-021-03030-8
PMID:33486574
Abstract

Immune checkpoint inhibitor (ICI) therapies, including the programmed cell death protein 1 (PD-1) axis blockade, are considered a major oncological breakthrough of the early twenty-first century and have led to remarkable response rates and survival in a subset of patients with non-small cell lung cancer (NSCLC). However, the available therapies work only for one in five unselected, advanced NSCLC patients; thus, patient selection needs to be performed with the use of efficient biomarkers. Although imperfect, programmed death-ligand 1 (PD-L1) expression by immunohistochemistry (IHC) on tumor cells and/or immune cells has been established as a predictive biomarker for response to the PD-1 axis blockade. There remain several pre-analytical, analytical, and post-analytical issues, however, before implementing a PD-L1 IHC assay(s) in the pathology laboratory. In addition, given the lack of robust sensitivity and specificity of PD-L1 IHC for predicting response to ICIs, other biomarkers including tumor mutation burden (TMB) are under investigation. In this review, issues associated with PD-L1 IHC and TMB estimations will be discussed, and other promising biomarkers for predicting response to ICIs will be briefly introduced.

摘要

免疫检查点抑制剂(ICI)治疗,包括程序性死亡蛋白 1(PD-1)轴阻断,被认为是 21 世纪早期的一个重大肿瘤学突破,并导致了一部分非小细胞肺癌(NSCLC)患者显著的反应率和生存率。然而,现有的治疗方法仅适用于五分之一未经选择的晚期 NSCLC 患者;因此,需要使用有效的生物标志物进行患者选择。尽管并不完美,但肿瘤细胞和/或免疫细胞的程序性死亡配体 1(PD-L1)表达的免疫组织化学(IHC)已被确立为预测 PD-1 轴阻断反应的生物标志物。然而,在病理实验室中实施 PD-L1 IHC 检测之前,仍然存在一些分析前、分析中和分析后的问题。此外,鉴于 PD-L1 IHC 预测对 ICI 反应的敏感性和特异性不足,包括肿瘤突变负荷(TMB)在内的其他生物标志物正在研究中。在这篇综述中,将讨论与 PD-L1 IHC 和 TMB 估计相关的问题,并简要介绍其他预测对 ICI 反应的有前途的生物标志物。

相似文献

[1]
Predictive biomarkers for response to immune checkpoint inhibitors in lung cancer: PD-L1 and beyond.

Virchows Arch. 2021-1

[2]
Robust Prediction of Immune Checkpoint Inhibition Therapy for Non-Small Cell Lung Cancer.

Front Immunol. 2021

[3]
Association of Survival and Immune-Related Biomarkers With Immunotherapy in Patients With Non-Small Cell Lung Cancer: A Meta-analysis and Individual Patient-Level Analysis.

JAMA Netw Open. 2019-7-3

[4]
Comparison of the Predictive Power of a Combination versus Individual Biomarker Testing in Non-Small Cell Lung Cancer Patients Treated with Immune Checkpoint Inhibitors.

Cancer Res Treat. 2022-4

[5]
Intrapatient variation in PD-L1 expression and tumor mutational burden and the impact on outcomes to immune checkpoint inhibitor therapy in patients with non-small-cell lung cancer.

Ann Oncol. 2024-10

[6]
Dual Biomarker Combining DNA Damage Repair Gene Mutations and PD-L1 Expression for Immune Checkpoint Inhibitors in Non-small Cell Lung Cancer.

Anticancer Res. 2023-5

[7]
PD-L1 polymorphisms predict survival outcomes in advanced non-small-cell lung cancer patients treated with PD-1 blockade.

Eur J Cancer. 2021-2

[8]
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Mol Oncol. 2021-4

[9]
PD-1/PD-L1 Blockade Therapy in Advanced Non-Small-Cell Lung Cancer: Current Status and Future Directions.

Oncologist. 2019-2

[10]
The association of efficacy with PD-1/PD-L1 inhibition and tumor mutational burden in advanced nonsmall cell lung cancer: A PRISMA-guided literature review and meta-analysis.

Medicine (Baltimore). 2022-7-22

引用本文的文献

[1]
A population-based nomogram for prognostic assessment in advanced lung cancer following progression with immune checkpoint inhibitor.

J Thorac Dis. 2025-7-31

[2]
Immunotherapy for Limited-Stage Small Cell Lung Cancer: Innovative Treatments and Future Perspectives.

Cancer Control. 2025

[3]
Checkpoint based immunotherapy in non-small cell lung cancer: a real-world retrospective study.

Front Immunol. 2024-11-27

[4]
A Pathologically Friendly Strategy for Determining the Organ-specific Spatial Tumor Microenvironment Topology in Lung Adenocarcinoma Through the Integration of snRandom-seq and Imaging Mass Cytometry.

Adv Sci (Weinh). 2024-7

[5]
The prognostic significance of PD-1 and its ligands in non-small cell lung cancer.

Turk Gogus Kalp Damar Cerrahisi Derg. 2024-1-29

[6]
Comparing deep learning and pathologist quantification of cell-level PD-L1 expression in non-small cell lung cancer whole-slide images.

Sci Rep. 2024-3-26

[7]
rs822336 binding to C/EBPβ and NFIC modulates induction of PD-L1 expression and predicts anti-PD-1/PD-L1 therapy in advanced NSCLC.

Mol Cancer. 2024-3-25

[8]
MicroRNAs as regulators of immune checkpoints in cancer immunotherapy: targeting PD-1/PD-L1 and CTLA-4 pathways.

Cancer Cell Int. 2024-3-10

[9]
Exploring histological predictive biomarkers for immune checkpoint inhibitor therapy response in non-small cell lung cancer.

J Pathol Transl Med. 2024-3

[10]
Pembrolizumab-combination therapy for NSCLC- effectiveness and predictive factors in real-world practice.

Front Oncol. 2024-1-23

本文引用的文献

[1]
The Genomic Landscape of Alterations and Associations with Outcomes in Patients with Lung Cancer.

Clin Cancer Res. 2020-11-1

[2]
Neoadjuvant Immunotherapy for NSCLC: Current Concepts and Future Approaches.

J Thorac Oncol. 2020-8

[3]
The Promises and Challenges of Tumor Mutation Burden as an Immunotherapy Biomarker: A Perspective from the International Association for the Study of Lung Cancer Pathology Committee.

J Thorac Oncol. 2020-9

[4]
The Society for Immunotherapy of Cancer statement on best practices for multiplex immunohistochemistry (IHC) and immunofluorescence (IF) staining and validation.

J Immunother Cancer. 2020-5

[5]
Programmed Death-Ligand 1 Heterogeneity and Its Impact on Benefit From Immune Checkpoint Inhibitors in NSCLC.

J Thorac Oncol. 2020-9

[6]
PD-L1 expression in cell-blocks of non-small cell lung cancer: The impact of prolonged fixation.

Diagn Cytopathol. 2020-7

[7]
Canadian Multicenter Project on Standardization of Programmed Death-Ligand 1 Immunohistochemistry 22C3 Laboratory-Developed Tests for Pembrolizumab Therapy in NSCLC.

J Thorac Oncol. 2020-8

[8]
Durvalumab With or Without Tremelimumab vs Standard Chemotherapy in First-line Treatment of Metastatic Non-Small Cell Lung Cancer: The MYSTIC Phase 3 Randomized Clinical Trial.

JAMA Oncol. 2020-5-1

[9]
Outcomes with durvalumab by tumour PD-L1 expression in unresectable, stage III non-small-cell lung cancer in the PACIFIC trial.

Ann Oncol. 2020-6

[10]
Harmonization and Standardization of Panel-Based Tumor Mutational Burden Measurement: Real-World Results and Recommendations of the Quality in Pathology Study.

J Thorac Oncol. 2020-7

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