Lung cancer immunotherapy response testing: PDL-1, TMB or an alternative?

At the British Thoracic Oncology Group (BTOG) Annual Conference 2018, held in Dublin, Ireland, Fred Hirsch, MD, PhD, of University of Colorado, Denver, CO, gave a very interesting talk on predictive response assays for lung cancer immunotherapy. Speaking from the meeting, Prof. Hirsch highlights the take-home points of his talk, raising thought-provoking questions for further consideration. These questions include: Are all mutations immunogenically equal? Should we combine PDL-1 and TMB assays? Should alternative markers, such as CTLA4 mRNA, be used? What other aspects of immune escape need to be considered?

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