Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Nat Rev Clin Oncol. 2021 Jun;18(6):345-362. doi: 10.1038/s41571-021-00473-5. Epub 2021 Feb 12.
Immune-checkpoint inhibitors targeting PD-1 or PD-L1 have already substantially improved the outcomes of patients with many types of cancer, although only 20-40% of patients derive benefit from these new therapies. PD-L1, quantified using immunohistochemistry assays, is currently the most widely validated, used and accepted biomarker to guide the selection of patients to receive anti-PD-1 or anti-PD-L1 antibodies. However, many challenges remain in the clinical use of these assays, including the necessity of using different companion diagnostic assays for specific agents, high levels of inter-assay variability in terms of both performance and cut-off points, and a lack of prospective comparisons of how PD-L1 disease diagnosed using each assay relates to clinical outcomes. In this Review, we describe the current role of PD-L1 immunohistochemistry assays used to inform the selection of patients to receive anti-PD-1 or anti-PD-L1 antibodies, we discuss the various technical and clinical challenges associated with these assays, including regulatory issues, and we provide some perspective on how to optimize PD-L1 as a selection biomarker for the future treatment of patients with solid tumours.
免疫检查点抑制剂针对 PD-1 或 PD-L1 的治疗已经显著改善了许多类型癌症患者的预后,尽管只有 20-40%的患者从这些新疗法中获益。PD-L1 可通过免疫组织化学检测来定量,目前是指导抗 PD-1 或抗 PD-L1 抗体治疗患者选择的最广泛验证、使用和接受的生物标志物。然而,这些检测方法在临床应用中仍存在许多挑战,包括需要为特定药物使用不同的伴随诊断检测方法、检测方法在性能和截止值方面存在高度的变异性,以及缺乏关于每种检测方法诊断的 PD-L1 疾病与临床结果的前瞻性比较。在这篇综述中,我们描述了目前用于指导选择接受抗 PD-1 或抗 PD-L1 抗体治疗的患者的 PD-L1 免疫组织化学检测的作用,我们讨论了与这些检测方法相关的各种技术和临床挑战,包括监管问题,并就如何优化 PD-L1 作为未来治疗实体瘤患者的选择生物标志物提供了一些看法。
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