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Hellmann Expands on TMB Testing in Lung Cancer

Caroline Seymour
Published: Thursday, Apr 19, 2018

Matthew D. Hellmann, MD
Matthew D. Hellmann, MD
PD-L1 and the recent emergence of tumor mutational burden (TMB) have helped guide physicians in selecting appropriate immunotherapy agents for patients with non–small cell lung cancer (NSCLC). Although the biomarkers are independent of each other, they have enabled practitioners to further predict the benefit of these therapies, explains Matthew D. Hellmann, MD.

State of the Science Summit™ on Advanced Non–Small Cell Lung Cancer, Hellman, an assistant attending physician at Memorial Sloan Kettering Cancer Center, discussed the expansion of these biomarkers across single-agent and combination therapies in patients with NSCLC.

OncLive: Please provide an overview of your presentation at the meeting.

Hellmann: One of the things that was discussed was the progress we've made in understanding who best benefits from immunotherapy. We have known about the opportunity for immunotherapy and the possibility of long-term outcomes that are not possible with other treatments in lung cancer for a long time, and that’s really given patients hope. I have a handful of patients who are doing well years after they started immunotherapy. That possibility didn't exist prior to immunotherapy, so it's been a huge breakthrough. However, only a small fraction of patients who receive immunotherapy have an exceptional benefit.

TMB is an emerging biomarker that is independent of PD-L1 and represents a new group of patients who can benefit from immunotherapy. We've made important progress in terms of identifying precision markers for use in immunotherapy.

Is TMB a predictive or prognostic factor?

When I first talked about TMB as a biomarker, it was largely in studies of patients in single-arm studies. People were uncertain about whether TMB was truly identifying predictive markers, or whether it was just identifying patients who happened to live longer.


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