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Giving an immunotherapy drug instead of chemotherapy as the first treatment did not help patients selected only by a moderate level of the PD-L1 protein. It is the trial that showed the threshold, not the drug, was the problem.
Patients with untreated stage IV or recurrent non-small-cell lung cancer and a PD-L1 tumour-expression level of 1% or more were randomly assigned to nivolumab or platinum-based chemotherapy. Among the 423 patients with a PD-L1 expression level of 5% or more, median progression-free survival was 4.2 months with nivolumab against 5.9 months with chemotherapy (hazard ratio 1.15) and median overall survival was 14.4 against 13.2 months (hazard ratio 1.02); 60% of the chemotherapy group crossed over to nivolumab. Treatment-related adverse events of grade 3 or 4 occurred in 18% with nivolumab and 51% with chemotherapy.
Read beside the pembrolizumab trial that succeeded at a 50% threshold in the same setting, it is the cleanest demonstration that a PD-L1 threshold is not a property of the protein but of the trial that drew the line.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), TMB-high (tumour mutational burden >= 10 mutations per megabase), Tumour mutational burden (TMB), Immunohistochemistry (IHC).
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), TMB-high (tumour mutational burden >= 10 mutations per megabase), Tumour mutational burden (TMB), PD-1 / PD-L1 immune checkpoint & T-cell activation.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation, Histopathology & immunohistochemistry.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation, Histopathology & immunohistochemistry.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation, Histopathology & immunohistochemistry.
Shares TMB-high (tumour mutational burden >= 10 mutations per megabase), Tumour mutational burden (TMB), PD-1 / PD-L1 immune checkpoint & T-cell activation, PD-L1.
Shares TMB-high (tumour mutational burden >= 10 mutations per megabase), Tumour mutational burden (TMB), PD-1 / PD-L1 immune checkpoint & T-cell activation, PD-L1.
Shares TMB-high (tumour mutational burden >= 10 mutations per megabase), Tumour mutational burden (TMB), PD-1 / PD-L1 immune checkpoint & T-cell activation, PD-L1.