Dr. Chaft on Predictive Biomarkers in Lung Cancer

Jamie E. Chaft, MD, a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center, discusses predictive biomarkers in lung cancer.

Rare mutations detected through next-generation sequencing have shown correlation to response in patients with advanced disease, says Chaft; however, tumor mutational burden (TMB) is a non–PD-L1 biomarker ​that appears to have utility in the lung cancer space​.

Although this biomarker has been subject to debate, TMB has a role in this space, according to Chaft. Research efforts should focus on centrally validating a way to test and define TMB, explains Chaft. 

Additionally, it is unknown whether patients who do not have high PD-L1 expression but have a high TMB will respond to immunotherapy, adds Chaft. Although it is likely that these patients will respond to this approach, prospective studies with monotherapies must be done in that patient population, especially given the toxicity concerns associated with ipilimumab (Yervoy) and nivolumab (Opdivo), says Chaft.

Although TMB appears to be the best biomarker thus far for immunotherapy, ​additional biomarkers are needed, as none of them are on par with established oncogene predictive markers, concludes Chaft.