Both agencies have modified the indications for pembrolizumab and atezolizumab such that the agents can now only be given to those patients who are ineligible for cisplatin-based chemotherapy or those with a certain level of programmed cell death ligand 1 (PD-L1) expression.

The authors of an accompanying commentary say that although the trial was positive, “atezolizumab efficacy remains far from that observed in fit patients with ECOG [performance status] 0–1 with high PD-L1 expression tumours (2-year overall survival rate of around 45%), clearly confirming comorbidities and performance status as major prognostic variables.”

A summary of the key trial publications on the use of PD-1 pathway and CTLA-4 inhibitors alone or in combination in the second-line or later treatment of locally advanced and metastatic urothelial carcinoma. This independent article was supported by an educational grant from Pfizer and Merck Healthcare KGaA, Darmstadt, Germany

Specifically, the cemiplimab–chemotherapy combination is indicated for adults with a tumoral PD-L1 expression level of at least 1% who do not harbor EGFR , ALK , or ROS1 alterations and who have locally advanced NSCLC not suitable for definitive chemoradiation or metastatic disease.

Participants were aged an average of 63 years and the majority (88.4%) received single-agent PD-1 or PD-L1 inhibitor therapy.

The OS benefit was observed despite almost half the patients in the chemotherapy alone arm crossing over to receive the PD-1 inhibitor as monotherapy, say Caicun Zhou (Tongji University School of Medicine, Shanghai, China) and co-authors in the Journal of Thoracic Oncology .

The overall survival benefit offered by immune checkpoint inhibitors in people with advanced non-small-cell lung cancer varies by age, suggests a real-world study.

Supplementing first-line chemotherapy with the PD-1 inhibitor toripalimab significantly improves the progression-free survival and overall survival of patients with advanced non-small-cell lung cancer, suggest Chinese trial data.

The addition of the anti-PD-1 agent serplulimab to chemotherapy significantly boosts the overall survival of treatment-naïve individuals with extensive-stage small-cell lung cancer, according to ASTRUM-005 trial results published in JAMA .

In this article, we provide an overview of the published trials of PD-1 pathway and CTLA-4 inhibitors – used as monotherapy, in combination with chemotherapy, or as maintenance – in the first-line treatment of locally advanced or metastatic urothelial cancer.

“This Kaplan–Meier ‘crossover gap’ in PFS has been observed in multiple other Phase 3 trials of anti-PD-L1/ PD-1 monotherapy versus chemotherapy and may reflect a subset of patients who respond better to cytotoxic chemotherapy and are refractory to an anti-PD-L1/PD-1 agent,” they continue.

The study included data on 121 individuals who received PD-1 or PD-L1 inhibitors for metastatic UC at one of three Canadian cancer centers between 2016 and 2021.

Bex presented an exploratory analysis of investigator-assessed DFS by PD-L1 status, which revealed “an interesting signal” hinting at a possible benefit of adjuvant atezolizumab in patients with PD-L1 expression levels of at least 5%, which “warrants further investigation.”

There was a similar pattern with use of the PD-L1 inhibitor after cCRT (unreached vs 32.4 months; stratified HR=0.75) and sCRT (unreached vs 24.1 months; stratified HR=0.60).

High tumor mutational burden is associated with a better response to immune checkpoint inhibitors in people with non-small-cell lung cancer across all levels of PD-L1 expression, US researchers report.

US researchers have identified “a protective association” between immune-related toxic effects – either disease flares or immune-related adverse events – in people with autoimmune disease receiving immune checkpoint inhibitors for cancer.

Adding the PD-L1 inhibitor adebrelimab to first-line chemotherapy significantly extends overall survival for patients with extensive-stage small-cell lung cancer, Chinese investigators report.

Targeting the PD-1/PD-L1 pathway and TGF-β can be accomplished without prohibitive safety concerns.

So now I think that in a view of maximizing small biopsies, it's better now to start directly with NGS with the exception of PD-L1, because PD-L1 we need to do immunohistochemistry.