When to test?

Biomarker testing at diagnosis of metastatic bladder cancer represents efficient use of biopsy tissue

  • PD-L1 testing at diagnosis is optimal. Early assessment of PD-L1 expression may aid identification of patients more likely to respond to anti-PD-1/PD-L1 immunotherapy.1,2
  • If PD-L1 testing was not performed at diagnosis, testing following disease progression (prior to initiation of 2L and later treatment) is also appropriate.3,4
  • If the result of a PD-L1 test was low/negative at diagnosis, a further test at progression may still be warranted.


  1. Balar AV, et al. Lancet Oncol 2017;389:67–76
  2. Balar AV, et al. Lancet Oncol 2017;18:1483–92
  3. Powles T, et al. JAMA Oncol 2017;3:e172411
  4. Rosenberg JE, et al. Lancet 2016;387:1909–20