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Soluble Biomarkers with Prognostic and Predictive Value in Advanced Non-Small Cell Lung Cancer Treated with
Beatriz Honrubia-Peris1, Javier Garde-Noguera1, Jose García-Sánchez1
1Medical Oncology Department, Hospital Arnau de Vilanova, Fundación para el Fomento de la Investigación Sanitaria i Biomédica de la Comunidad Valenciana (FISABIO), 46020 Valencia, Spain.
Abstract:
Numerous targeted therapies have been evaluated for the treatment of non-small cell lung cancer (NSCLC). To date, however, only a few agents have shown promising results. Recent advances in cancer immunotherapy, most notably immune checkpoint inhibitors (ICI), have transformed the treatment scenario for these patients. Although some patients respond well to ICIs, many patients do not benefit from ICIs, leading to disease progression and/or immune-related adverse events. New biomarkers capable of reliably predicting response to ICIs are urgently needed to improve patient selection. Currently available biomarkers-including programmed death protein 1 (PD-1) and its ligand (PD-L1), and tumor mutational burden (TMB)-have major limitations. At present, no well-validated, reliable biomarkers are available. Ideally, these biomarkers would be obtained through less invasive methods such as plasma determination or liquid biopsy. In the present review, we describe recent advances in the development of novel soluble biomarkers (e.g., circulating immune cells, TMB, circulating tumor cells, circulating tumor DNA, soluble factor PD-L1, tumor necrosis factor, etc.) for patients with NSCLC treated with ICIs. We also describe the potential use of these biomarkers as prognostic indicators of treatment response and toxicity.
Insights
New soluble biomarkers are needed to predict non-small cell lung cancer (NSCLC) patient response to immune checkpoint inhibitors (ICI). This review explores novel liquid biopsy biomarkers for improved NSCLC treatment selection and toxicity prediction.
Area of Science:
- Oncology
- Immunology
- Biomarker Discovery
Background:
- Non-small cell lung cancer (NSCLC) treatment has advanced with immune checkpoint inhibitors (ICI).
- However, many NSCLC patients do not respond to ICI therapy, necessitating better patient selection methods.
- Current biomarkers like PD-1/PD-L1 and tumor mutational burden (TMB) have significant limitations.
Purpose of the Study:
- To review recent advances in novel soluble biomarkers for predicting ICI response in NSCLC.
- To explore the potential of these biomarkers, obtainable via liquid biopsy, for patient selection.
- To discuss their role as prognostic indicators for treatment response and toxicity.
Main Methods:
- Review of current literature on soluble biomarkers for NSCLC treated with ICI.
- Focus on novel biomarkers including circulating immune cells, TMB, circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), and soluble PD-L1.
- Discussion of minimally invasive methods like plasma determination.
Main Results:
- Existing biomarkers for ICI response in NSCLC (PD-1, PD-L1, TMB) have limitations.
- Novel soluble biomarkers show promise for predicting treatment outcomes.
- Liquid biopsy offers a less invasive approach to biomarker assessment.
Conclusions:
- There is an urgent need for validated, reliable biomarkers to guide ICI therapy in NSCLC.
- Soluble biomarkers, assessed through liquid biopsy, represent a promising avenue for improving patient selection.
- These biomarkers may also predict treatment response and toxicity, optimizing NSCLC management.
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