Janice Mehnert, MD, medical oncologist, director, Phase I and Developmental Therapeutics Program, Rutgers Cancer Institute of New Jersey, discusses challenges with identifying effective biomarkers in for immunotherapy agents. 

The immune system is in constant flux, and because of that everyboyd’s immune response is different, says Mehnert.

The immune response that is induced by checkpoint inhibitors is going to vary from patient to patient, and it also varies from disease to disease. Part of the challenge is that there are now drugs that have activity in many different tumor types, which is sort of an unprecedented paradigm in oncology, says Mehnert.

Immunotherapies do not work the same in all of those tumor types, even toxicity may be different from disease type to disease type. This may mean that doses will have to be different for different diseases. This is not something that most oncologists are used, says Mehnert.

The immune system is very dynamic which is another challenge in determining biomarkers, says Mehnert.

Immunotherapy biomarker testing is not quite as clear-cut as other genomics tests, where it’s possible to do PCR and find a mutation, and really have a clean line between target and treatment, says Mehnert.

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​Janice Mehnert, MD, medical oncologist, director, Phase I and Developmental Therapeutics Program, Rutgers Cancer Institute of New Jersey, discusses challenges with identifying effective biomarkers in for immunotherapy agents.

Dr. Janice Mehnert on Why it's a Challenge to Identify Biomarkers for Immunotherapy

Janice Mehnert, MD, medical oncologist, director, Phase I and Developmental Therapeutics Program, Rutgers Cancer Institute of New Jersey, discussing promising biomarkers for patients to receive immunotherapy across tumor types.

Across the field, researchers have concluded that PD-L1 expression is important—though it is far from perfect, especially because the various assays available are not standardized, Mehnert explains. Additionally, it is unclear whether it matters more or less in one tumor type versus another.

Researchers should also be studying other factors, such as next-generation sequencing as a surrogate for whole-exome sequencing to identify extreme cases of high mutational load that could be predictive, she adds.

Janice Mehnert, MD

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Dr. Janice Mehnert on Why it's a Challenge to Identify Biomarkers for Immunotherapy

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