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Dr. Herbst on TMB as a Biomarker in NSCLC

Roy S. Herbst, MD, PhD
Published: Friday, Aug 03, 2018



Roy S. Herbst, MD, PhD, professor of medicine, chief of medical oncology, Yale Cancer Center and Smilow Cancer Hospital, discusses tumor mutational burden (TMB) as a biomarker in non–small cell lung cancer (NSCLC).

TMB is a very interesting biomarker, says Herbst, and it’s been tested frequently with patients with NSCLC, with many assays being cross-validated. Data coming from the IMpower and CheckMate trials are very compelling. There’s no doubt that TMB correlates with outcomes for patients receiving immunotherapy. However, research is left to be done to see if this differentiates immunotherapy from chemotherapy or immunotherapy from a combination regimen. There are some hints that physicians can use TMB to administer the immunotherapy combination of ipilimumab (Yervoy) and nivolumab (Opdivo), Herbst says.

Herbst adds that testing for TMB and PD-L1 expression could soon be used in a dichotomous way. For example, if a patient is PD-L1 negative and has no detectable TMB, this is a good case to determine a way to rev up the immune system.


Roy S. Herbst, MD, PhD, professor of medicine, chief of medical oncology, Yale Cancer Center and Smilow Cancer Hospital, discusses tumor mutational burden (TMB) as a biomarker in non–small cell lung cancer (NSCLC).

TMB is a very interesting biomarker, says Herbst, and it’s been tested frequently with patients with NSCLC, with many assays being cross-validated. Data coming from the IMpower and CheckMate trials are very compelling. There’s no doubt that TMB correlates with outcomes for patients receiving immunotherapy. However, research is left to be done to see if this differentiates immunotherapy from chemotherapy or immunotherapy from a combination regimen. There are some hints that physicians can use TMB to administer the immunotherapy combination of ipilimumab (Yervoy) and nivolumab (Opdivo), Herbst says.

Herbst adds that testing for TMB and PD-L1 expression could soon be used in a dichotomous way. For example, if a patient is PD-L1 negative and has no detectable TMB, this is a good case to determine a way to rev up the immune system.



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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