Molecular markers and prediction of response to immunotherapy in non-small cell lung cancer, an update.
Fiche publication
Date publication
janvier 2019
Journal
Journal of thoracic disease
Auteurs
Membres identifiés du Cancéropôle Est :
Dr OUDART Jean-Baptiste
Tous les auteurs :
Blons H, Garinet S, Laurent-Puig P, Oudart JB
Lien Pubmed
Résumé
Immunotherapy represents one of the most promising therapeutic approaches in lung cancer, however 50% of lung cancer patients will not respond to this treatment, while others will have transitory or durable responses. Because side effects may be life threatening and treatment costs remain very high, the identification of predictive markers is mandatory and actually extensively studied. Factors that determine response to immune checkpoint inhibitors (ICI) are numerous including tumor microenvironment, immune tumor infiltrates, expression of immune checkpoint proteins (PD-1/PD-L1), gene expression signatures and molecular tumor profiles. Based on high impact factor publications and recent literature this review focuses on the potential predictive value of tumor molecular alterations and tumor mutation burden as predictive markers of response or resistance to ICI. We also discuss the role of circulating tumor DNA (ctDNA) to monitor ICI responses and propose an algorithm that integrates molecular markers upcoming recommendations for first line treatment.
Mots clés
Lung cancer, immunotherapy, next generation sequencing (NGS), oncogene drivers, tumor mutation load (TML)
Référence
J Thorac Dis. 2019 Jan;11(Suppl 1):S25-S36