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.
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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.

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Online CME Activities
TitleExpiration DateCME Credits
Year in Review™: Reflecting on Recent Evidence With an Eye to the Future of Lung Cancer ManagementMar 30, 20191.5
Online Medical Crossfire®: 5th Annual Miami Lung Cancer ConferenceMay 30, 20196.5
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