Dr. Levy on Investigational Biomarkers of Response to Immunotherapy in NSCLC

Benjamin P. Levy, MD, assistant professor of oncology, clinical director of medical oncology, Johns Hopkins Sidney Kimmel Cancer Center, Johns Hopkins Medicine, discusses investigational biomarkers of response to immunotherapy in non—small cell lung cancer (NSCLC).

At Johns Hopkins Medicine, physicians are still working on validating tumor mutational burden before implementing it in routine practice. Markers that are routinely tested for include PD-L1 and EGFR-mutations, but KRAS is also considered, explains Levy. Physicians at Johns Hopkins Medicine will do a next-generation panel that reveals the co-alterations with KRAS as well. LKB1, a marker that may demonstrate lack of benefit to immunotherapy, is also tested in the next-generation panel, says Levy.

Those are the markers that can be routinely interrogated, but there are other future biomarkers that are being looked at in clinical trials, explains Levy. One is longitudinal circulating tumor DNA (ctDNA) assessment, which looks at changes in ctDNA over time as a predictor of efficacy to immunotherapy. Another approach is looking at the microbial elements in stool to better understand which microbes may help predict efficacy to immunotherapy versus those that do not.