Dr. Levy on Biomarkers of Response to Immunotherapy

Benjamin P. Levy, MD, assistant professor of oncology, clinical director of medical oncology, Johns Hopkins Sidney Kimmel Cancer Center, Johns Hopkins Medicine, discusses biomarkers of response to immunotherapy.

It is as important to have biomarkers that predict response to immunotherapy and lack thereof, explains Levy. PD-L1, though not perfect, remains a biomarker of response with a cut-off point of 50% that is often used to drive decision making. Other biomarkers are beginning to enter the field, such as tumor mutational burden (TMB). TMB may be able to predict efficacy to either single-agent checkpoint inhibitors or dual checkpoint blockade, as suggested by recent data published in the New England Journal of Medicine, says Levy.

There are also emerging biomarkers that are showing predictive value, explains Levy, such as KRAS alongside p53. A recent study showed that if a patient has those 2 alterations together, there may be a higher likelihood of response to immunotherapy.

Mutations that predict lack of benefit to immunotherapy include EGFR mutations, at least for single-agent checkpoint inhibitors. The presence of this mutation can be used to deter physicians from using immunotherapy. Additionally, LKB1 or STK11 mutations may also predict lack of benefit to immunotherapy. These are readily available mutations to investigate that may soon help guide decision making, concludes Levy.