Dr. Balar on PD-L1 Testing for Urothelial Cancer

Arjun V. Balar, MD, assistant professor of medicine, Division of Hematology and Oncology, Perlmutter Cancer Center, NYU Langone Medical Center, discusses PD-L1 testing and the development of biomarkers for PD-L1 antibodies for patients with urothelial carcinoma.

According to Balar, what is useful about PD-L1 testing is the enrichment for responses. The challenge is that even PD-L1—negative patients still had a response rate of 20%. This leads physicians to conclude that PD-L1 testing is not useful to exclude patients. However, if they have a high PD-L1 score, they have at least a 50% chance of responding to therapy.

Choosing a PD-1/PD-L1 antibody is difficult to do, explains Balar. All of the available agents seems to have comparable response rates and safety profiles. However, to have different choices that can be tailored to a patient’s individual needs will drive the decision of treatment.