Dr. Bunn on TMB as a Biomarker in Small Cell Lung Cancer

Paul A. Bunn Jr, MD
Published: Wednesday, Aug 15, 2018



Paul A. Bunn Jr, MD, distinguished professor, Division of Medical Oncology, James Dudley Chair in Lung Cancer Research, University of Colorado Denver, 2014 Giant of Cancer Care® in Lung Cancer, discusses tumor mutational burden (TMB) as a biomarker in small cell lung cancer (SCLC).

Patients with SCLC typically have low PD-L1 expression, so using that as a biomarker won’t be very effective. Since SCLC is a diagnosis specific to smokers, these patients usually have high TMB. There is some evidence that TMB is a good biomarker, particularly with the addition of CTLA-4 inhibitors.

Bunn mentions a study of single-agent pembrolizumab (Keytruda), which demonstrated a 30% response rate in patients. The impressive thing about the responses was the durability—patients lived up to 2 years on pembrolizumab, which is much longer than chemotherapy.


Paul A. Bunn Jr, MD, distinguished professor, Division of Medical Oncology, James Dudley Chair in Lung Cancer Research, University of Colorado Denver, 2014 Giant of Cancer Care® in Lung Cancer, discusses tumor mutational burden (TMB) as a biomarker in small cell lung cancer (SCLC).

Patients with SCLC typically have low PD-L1 expression, so using that as a biomarker won’t be very effective. Since SCLC is a diagnosis specific to smokers, these patients usually have high TMB. There is some evidence that TMB is a good biomarker, particularly with the addition of CTLA-4 inhibitors.

Bunn mentions a study of single-agent pembrolizumab (Keytruda), which demonstrated a 30% response rate in patients. The impressive thing about the responses was the durability—patients lived up to 2 years on pembrolizumab, which is much longer than chemotherapy.

View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Community Practice Connections™: 18th Annual International Lung Cancer Congress®Oct 31, 20181.5
Clinical Interchange™: Translating Research to Inform Changing Paradigms: Assessment of Emerging Immuno-Oncology Strategies and Combinations across Lung, Head and Neck, and Bladder CancersOct 31, 20182.0
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