Dr. Villaruz Discusses PD-L1 Expression in Lung Cancer

Liza C. Villaruz, MD, assistant professor of medicine, Division of Hematology/Oncology, University of Pittsburgh, discusses PD-L1 expression in lung cancer.

The level of PD-L1 expression is the most important factor in the selection of immunotherapy for patients with lung cancer, says Villacruz. For patients who have an overexpression of PD-L1 in their tumors, Villacruz says that she usually prescribes single-agent pembrolizumab (Keytruda). This is due to the significant response rates of about 45%, but that rate of response can be increased with the addition of chemotherapy.

This comparison needs to be taken with a grain of salt, Villacruz says, as the data with pembrolizumab and the data with pembrolizumab plus chemotherapy have not been studied head-to-head. With that being said, Villacruz says that in patients who express less than 50% PD-L1, her standard of care is pembrolizumab plus chemotherapy. For patients who overexpress PD-L1, pembrolizumab monotherapy is still Villacruz’s first choice.