Dr. Joel Neal on Impact of PD-L1 Tests on Pembrolizumab, Nivolumab Efficacy in Frontline NSCLC

Joel Neal, MD, PhD, assistant professor of Medicine (Oncology), Stanford University Medical Center, discusses how PD-L1 testing may have played a role in the survival differences between frontline pembrolizumab and nivolumab in non—small-cell lung cancer (NSCLC).

The PD-L1 28-8 pharmDx by Immunohistochemistry (IHC) with Interpretation, the PD-L1 test used with nivolumab, captures a wider group of positive patients than the PD-L1 22C3 IHC assay, the diagnostic test used with pembrolizumab which is more selective, says Neal.

The atezolizumab test, the SP142 PD-L1 assay, appears to have the fewest positives out of all of the tests. All three of these tests are accepting a different positive group, says Neal.

The differences in testing between nivolumab and pembrolizumab may have lead to the differences in their individual frontline lung cancer trials, he says. The patients with the tumors that express the highest levels of PD-L1 are the most likely to respond in the frontline setting.