Dr. Clarke on the State of Biomarkers in NSCLC

Jeffrey M. Clarke, MD, assistant professor of medicine, Duke Cancer Institute, discusses the evolution of biomarkers in directing treatment for patients with non—small cell lung cancer (NSCLC).

The use of biomarkers in NSCLC can help guide treatment. Biomarkers can be classified by genotyping and immune therapy. There are a couple of different ways to perform genotyping for lung cancer patients, either using tissue-based or plasma-based methods. Plasma-based methods, such as the use of liquid biopsies, can be particularly useful in sparing patients from the risks of tissue-based procedures.

On the immune-oncology side, PD-L1 measurement and expression remains the most well-validated and widely used biomarker in lung cancer, says Clarke. PD-L1 is a dynamic and heterogeneous biomarker, but it can be problematic because patients can have high expression and not respond to immune therapy and have low expression and respond well to immunotherapy.