Expectations of Oncologist from the Pathologist in Immunotherapy

tibbionko-17-1-kapak

Nalan AKYÜREKa
aGazi University Faculty of Medicine, Department of Medical Pathology, Ankara, Türkiye

Akyürek N. Expectations of oncologist from the pathologist in immunotherapy. In: Şendur MAN, ed. Current Immunotherapy Landscape for Solid Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.12-7.

ABSTRACT
Pathologists play a vital role in the development and implementation of biomarker testing in cancer immunotherapy. Pathologists’ expertise is crucial in interpreting biomarker results and guiding treatment decisions based on these findings. PD-L1, microsatellite instability/defective mismatch repair (MSI/dMMR) and tumor mutational burden (TMB) have emerged as the most widely investigated biomarkers for predicting response to immune checkpoint inhibitors. However, the standardization of biomarker assays and the integration of liquid biopsy as a non-invasive method are critical for their clinical implementation. Moreover, the combination of multiple biomarkers and the exploration of novel biomarkers hold promise for enhancing the predictive power of immunotherapy response. Continued research and collaboration are essential to to refine and validate these biomarkers, enabling personalized treatment decisions and improving patient outcomes in the era of immunotherapy.

Keywords: Immunotherapy; predictive biomarkers; programmed cell death ligand 1 (PD-L1)

Referanslar

  1. Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer. 2012;12(4):252-64. [Crossref]  [PubMed]  [PMC]
  2. Akinleye A, Rasool Z. Immune checkpoint inhibitors of PD-L1 as cancer therapeutics. J Hematol Oncol. 2019;12(1):92. [Crossref]  [PubMed]  [PMC]
  3. Darvin P, Toor SM, Sasidharan Nair V, Elkord E. Immune checkpoint inhibitors: recent progress and potential biomarkers. Exp Mol Med. 2018;50(12):1-11. [Crossref]  [PubMed]  [PMC]
  4. Picardo SL, Doi J, Hansen AR. Structure and Optimization of Checkpoint Inhibitors. Cancers (Basel). 2019;12(1):38. [Crossref]  [PubMed]  [PMC]
  5. Ribas A, Wolchok JD. Cancer immunotherapy using checkpoint blockade. Science. 2018;359(6382):1350-5. [Crossref]  [PubMed]  [PMC]
  6. Schmid P, Adams S, Rugo HS, Schneeweiss A, Barrios CH, Iwata H, et al.; IMpassion130 Trial Investigators. Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer. N Engl J Med. 2018;379(22):2108-21. [Crossref]  [PubMed]
  7. Sun L, Zhang L, Yu J, Zhang Y, Pang X, Ma C, et al. Clinical efficacy and safety of anti-PD-1/PD-L1 inhibitors for the treatment of advanced or metastatic cancer: a systematic review and meta-analysis. Sci Rep. 2020;10(1):2083. [Crossref]  [PubMed]  [PMC]
  8. Wei SC, Duffy CR, Allison JP. Fundamental Mechanisms of Immune Checkpoint Blockade Therapy. Cancer Discov. 2018;8(9):1069-86. [Crossref]  [PubMed]
  9. Binnewies M, Roberts EW, Kersten K, Chan V, Fearon DF, Merad M, et al. Understanding the tumor immune microenvironment (TIME) for effective therapy. Nat Med. 2018;24(5):541-50. [Crossref]  [PubMed]  [PMC]
  10. Darr C, Hilser T, Kesch C, Isgandarov A, Reis H, Wahl M, et al. Immune-Checkpoint-Inhibitor Therapy-Principles and Relevance of Biomarkers for Pathologists and Oncologists. Adv Anat Pathol. 2023;30(3):160-6. [Crossref]  [PubMed]
  11. Kuczkiewicz-Siemion O, Sokół K, Puton B, Borkowska A, Szumera-Ciećkiewicz A. The Role of Pathology-Based Methods in Qualitative and Quantitative Approaches to Cancer Immunotherapy. Cancers (Basel). 2022;14(15):3833. [Crossref]  [PubMed]  [PMC]
  12. Miyake M, Hori S, Owari T, Oda Y, Tatsumi Y, Nakai Y, et al. Clinical Impact of Tumor-Infiltrating Lymphocytes and PD-L1-Positive Cells as Prognostic and Predictive Biomarkers in Urological Malignancies and Retroperitoneal Sarcoma. Cancers (Basel). 2020;12(11):3153. [Crossref]  [PubMed]  [PMC]
  13. Gutic B, Bozanovic T, Mandic A, Dugalic S, Todorovic J, Stanisavljevic D, et al. Programmed cell death-1 and its ligands: Current knowledge and possibilities in immunotherapy. Clinics (Sao Paulo). 2023;78:100177. [Crossref]  [PubMed]  [PMC]
  14. Mathew M, Safyan RA, Shu CA. PD-L1 as a biomarker in NSCLC: challenges and future directions. Ann Transl Med. 2017;5(18):375. [Crossref]  [PubMed]  [PMC]
  15. Davis AA, Patel VG. The role of PD-L1 expression as a predictive biomarker: an analysis of all US Food and Drug Administration (FDA) approvals of immune checkpoint inhibitors. J Immunother Cancer. 2019;7(1):278. [Crossref]  [PubMed]  [PMC]
  16. Ledford H. Melanoma drug wins US approval. Nature. 2011;471(7340):561. [Crossref]  [PubMed]
  17. Wojtukiewicz MZ, Rek MM, Karpowicz K, Górska M, Polityńska B, Wojtukiewicz AM, et al. Inhibitors of immune checkpoints-PD-1, PD-L1, CTLA-4-new opportunities for cancer patients and a new challenge for internists and general practitioners. Cancer Metastasis Rev. 2021;40(3):949-82. [Crossref]  [PubMed]  [PMC]
  18. Marin-Acevedo JA, Kimbrough EO, Lou Y. Next generation of immune checkpoint inhibitors and beyond. J Hematol Oncol. 2021;14(1):45. [Crossref]  [PubMed]  [PMC]
  19. Topalian SL, Drake CG, Pardoll DM. Immune checkpoint blockade: a common denominator approach to cancer therapy. Cancer Cell. 2015;27(4):450-61. [Crossref]  [PubMed]  [PMC]
  20. Vranic S, Gatalica Z. PD-L1 testing by immunohistochemistry in immuno-oncology. Biomol Biomed. 2023;23(1):15-25. [Crossref]
  21. Chebib I, Mino-Kenudson M. PD-L1 immunohistochemistry: Clones, cutoffs, and controversies. APMIS. 2022;130(6):295-313. [Crossref]  [PubMed]
  22. Prince EA, Sanzari JK, Pandya D, Huron D, Edwards R. Analytical Concordance of PD-L1 Assays Utilizing Antibodies From FDA-Approved Diagnostics in Advanced Cancers: A Systematic Literature Review. JCO Precis Oncol. 2021;5:953-73. [Crossref]  [PubMed]  [PMC]
  23. Kavun A, Veselovsky E, Lebedeva A, Belova E, Kuznetsova O, Yakushina V, et al. Microsatellite Instability: A Review of Molecular Epidemiology and Implications for Immune Checkpoint Inhibitor Therapy. Cancers (Basel). 2023;15(8):2288. [Crossref]  [PubMed]  [PMC]
  24. U.S. Food & Drug Administration. FDA grants accelerated approval to pembrolizumab for first tissue/site agnostic indication. Web site. [Cited: Nov 10th, 2020]. [Link]
  25. U.S. Food & Drug Administration. FDA grants nivolumab accelerated approval for MSI-H or dMMR colorectal cancer. Web site. [Cited: Nov 10th, 2020]. [Link]
  26. Arends M, Frayling I, Happerfield L, Ibrahim M. HNPCC/Lynch syndrome module: report of the immunohistochemical analysis of mismatch repair (MMR) protein expression. UK NEQAS ICC & ISH Recommendations. 2010;8.
  27. Liu T, Wahlberg S, Burek E, Lindblom P, Rubio C, Lindblom A. Microsatellite instability as a predictor of a mutation in a DNA mismatch repair gene in familial colorectal cancer. Genes Chromosomes Cancer. 2000;27(1):17-25. [Crossref]
  28. Chen W, Swanson BJ, Frankel WL. Molecular genetics of microsatellite-unstable colorectal cancer for pathologists. Diagn Pathol. 2017;12(1):24. [Crossref]  [PubMed]  [PMC]
  29. Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group. Recommendations from the EGAPP Working Group: genetic testing strategies in newly diagnosed individuals with colorectal cancer aimed at reducing morbidity and mortality from Lynch syndrome in relatives. Genet Med. 2009;11(1):35-41. [Crossref]  [PubMed]  [PMC]
  30. Müller A, Giuffre G, Edmonston TB, Mathiak M, Roggendorf B, Heinmöller E, et al.; German HNPCC Consortium German Cancer Aid (Deutsche Krebshilfe). Challenges and pitfalls in HNPCC screening by microsatellite analysis and immunohistochemistry. J Mol Diagn. 2004;6(4):308-15. [Crossref]  [PubMed]
  31. Vanderwalde A, Spetzler D, Xiao N, Gatalica Z, Marshall J. Microsatellite instability status determined by next-generation sequencing and compared with PD-L1 and tumor mutational burden in 11,348 patients. Cancer Med. 2018;7(3):746-56. Erratum in: Cancer Med. 2018;7(6):2792. [Crossref]  [PubMed]  [PMC]
  32. Administration USFD. FDA approves pembrolizumab for adults and children with TMB-H solid tumors. Web site. [Cited: Nov 10th, 2020]. [Link]
  33. Sadeghi Rad H, Monkman J, Warkiani ME, Ladwa R, O'Byrne K, Rezaei N, et al. Understanding the tumor microenvironment for effective immunotherapy. Med Res Rev. 2021;41(3):1474-98. [Crossref]  [PubMed]  [PMC]
  34. Petitprez F, Meylan M, de Reyniès A, Sautès-Fridman C, Fridman WH. The Tumor Microenvironment in the Response to Immune Checkpoint Blockade Therapies. Front Immunol. 2020;11:784. [Crossref]  [PubMed]  [PMC]
  35. Bai R, Lv Z, Xu D, Cui J. Predictive biomarkers for cancer immunotherapy with immune checkpoint inhibitors. Biomark Res. 2020;8:34. [Crossref]  [PubMed]  [PMC]
  36. Yang Y, Liu H, Chen Y, Xiao N, Zheng Z, Liu H, et al. Liquid biopsy on the horizon in immunotherapy of non-small cell lung cancer: current status, challenges, and perspectives. Cell Death Dis. 2023;14(3):230. [Crossref]  [PubMed]  [PMC]