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In patients whose lung cancer had the highest levels of the PD-L1 protein and no targetable mutation, an immunotherapy drug given alone added about seven months of life compared with chemotherapy.
Patients with metastatic non-squamous or squamous non-small-cell lung cancer who had not received chemotherapy and whose tumours expressed PD-L1 on at least 1% of tumour cells or at least 1% of tumour-infiltrating immune cells by the SP142 assay were randomly assigned to atezolizumab or platinum-based chemotherapy. Overall survival was tested hierarchically by PD-L1 expression among patients whose tumours were wild-type for EGFR and ALK. Of 572 patients enrolled, in the 205 with the highest PD-L1 expression and wild-type EGFR and ALK, median overall survival was 20.2 months with atezolizumab against 13.1 months with chemotherapy, hazard ratio 0.59. Grade 3 or 4 adverse events occurred in 30.1% with atezolizumab and 52.5% with chemotherapy. Survival also favoured atezolizumab in the subgroups with high blood-based tumour mutational burden.
It is the reason the SP142 assay and its two-compartment score remain in use despite being the least comparable of the PD-L1 assays: the atezolizumab threshold was defined on it and cannot simply be translated to another stain.
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), PD-L1 IC score (immune-cell score, SP142), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), PD-L1 IC score (immune-cell score, SP142), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation.
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), PD-L1 IC score (immune-cell score, SP142), Immunohistochemistry (IHC), PD-1 / PD-L1 immune checkpoint & T-cell activation.
Shares PD-L1 TC score (tumour-cell score, SP263 and 28-8), VENTANA PD-L1 (SP142) Assay, Immunohistochemistry (IHC), 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, Atezolizumab.
Shares PD-L1 IC score (immune-cell score, SP142), VENTANA PD-L1 (SP142) Assay, PD-L1, New England Journal of Medicine.