Patients Selection for Immunotherapy in Solid Tumors: Overcome the Naïve Vision of a Single Biomarker

Biomed Res Int. 2019 Apr 24:2019:9056417. doi: 10.1155/2019/9056417. eCollection 2019.

Abstract

Immunotherapy, and in particular immune-checkpoints blockade therapy (ICB), represents a new pillar in cancer therapy. Antibodies targeting Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) and Programmed Death 1 (PD-1)/Programmed Death Ligand-1 (PD-L1) demonstrated a relevant clinical value in a large number of solid tumors, leading to an improvement of progression free survival and overall survival in comparison to standard chemotherapy. However, across different solid malignancies, the immune-checkpoints inhibitors efficacy is limited to a relative small number of patients and, for this reason, the identification of positive or negative predictive biomarkers represents an urgent need. Despite the expression of PD-L1 was largely investigated in various malignancies, (i.e., melanoma, head and neck malignancies, urothelial and renal carcinoma, metastatic colorectal cancer, and pancreatic cancer) as a biomarker for ICB treatment-patients selection, it showed an important, but still imperfect, role as positive predictor of response only in nonsmall cell lung cancer (NSCLC). Importantly, other tumor and/or microenvironments related characteristics are currently under clinical evaluation, in combination or in substitution of PD-L1 expression. In particular, tumor-infiltrating immune cells, gene expression analysis, mismatch- repair deficiency, and tumor mutational landscape may play a central role in predicting clinical benefits of CTLA-4 and/or PD-1/PD-L1 checkpoint inhibitors. In this review, we will focus on the clinical evaluation of emerging biomarkers and how these may improve the naïve vision of a single- feature patients-based selection.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • B7-H1 Antigen / metabolism
  • Biomarkers, Tumor*
  • Breast Neoplasms
  • CTLA-4 Antigen / metabolism
  • Carcinoma, Non-Small-Cell Lung
  • Carcinoma, Renal Cell / drug therapy
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / genetics
  • Gastrointestinal Neoplasms / drug therapy
  • Head and Neck Neoplasms
  • Humans
  • Immunotherapy / methods*
  • Kidney Neoplasms / drug therapy
  • Lung Neoplasms / drug therapy
  • Melanoma
  • Neoplasms / drug therapy*
  • Neoplasms / genetics
  • Pancreatic Neoplasms / drug therapy
  • Programmed Cell Death 1 Receptor / metabolism

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • B7-H1 Antigen
  • Biomarkers, Tumor
  • CD274 protein, human
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor