Operationalizing Screening for Non-Small Cell Lung Cancer: An International Discussion - Episode 8
Deciphering Biomarker Results for Adjuvant Immunotherapy in NSCLC
Experts address the complex role of PD-L1 testing in guiding adjuvant immunotherapy after surgery for resected NSCLC. They highlight the ongoing uncertainty, particularly for PD-L1 negative patients, where clinical trial data is conflicting—some studies show no benefit or even potential harm.
The discussion underscores that the benefit of adjuvant immunotherapy is most clear in PD-L1 positive patients. For PD-L1 negative patients, the decision becomes a nuanced discussion with the patient about unproven benefits versus the risk of side effects. The experts note that tumor heterogeneity and changes in PD-L1 expression after treatment (like radiotherapy) add further complexity. They conclude that better biomarkers, such as ctDNA for minimal residual disease (MRD), are urgently needed to more accurately identify which patients will truly benefit from post-operative immunotherapy, moving beyond PD-L1 alone.
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