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Expert Discusses the Role of PD-L1 Expression as a Predictive Biomarker in Urothelial Carcinoma

Robert Dreicer, MD
Published Online:3:10 PM, Fri September 20, 2019




Robert Dreicer, MD, associate director for clinical research and the deputy director of the University of Virginia Cancer Center, discusses the role of biomarkers to predict response to immunotherapy in patients with urothelial carcinoma. He highlights the current status of using PD-L1 expression as a predictive biomarker to immunotherapy.

PD-L1 expression is not necessarily useful in deciding which patients with urothelial carcinoma will respond to checkpoint inhibition because patients that don’t express PD-L1 can still respond to this type of therapy, Dreicer says. However, an FDA guidance says that PD-L1 expression may be useful when treating patients in the frontline with single-agent checkpoint inhibitors and that patients who are platinum eligible and have low PD-L1 expression should not receive immune checkpoint inhibitor monotherapy.

The data from frontline studies have yet to be reported, so Dreicer says further data are needed for validation. However, he adds that the combination of different biomarkers, such as tumor mutational burden, and other molecular subtypes of urothelial carcinoma may provide more information about selection.
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