Dr. Perez-Soler on Current Status of Biomarkers in SCLC

Roman Perez-Soler, MD, chairman of the Department of Oncology and chief of the Division of Medical Oncology at Montefiore Medical Center, discusses the current status of biomarkers in small cell lung cancer (SCLC).

PD-L1 expression and tumor mutational burden (TMB) are the most prominent biomarkers for immune response in lung cancer. However, although both have merit, Perez-Soler says they are not as reliable as researchers would hope. In the case of PD-L1, just because a patient is considered PD-L1—positive, does not necessarily mean that they will derive benefit from immunotherapy.

PD-L1 negativity has been suggested as a biomarker for immune resistance, but some of these patients might still benefit from treatment, Perez-Soler says, and, as such, he would give a checkpoint inhibitor regardless.

Perez-Soler notes that physicians should give the “benefit of the doubt” when assessing their patients for these biomarkers. Just because a patient’s biopsy shows up as PD-L1—negative does not necessarily mean that their entire tumor is negative; therefore, to decline treatment based off of the current biomarkers might be too drastic of a decision.