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

PD-L1 testing at diagnosis of metastatic bladder cancer represents efficient use of biopsy tissue

  • Tumour tissue biopsied via cystoscopy or transurethral resection of the bladder tumour (TURBT) can undergo efficient concurrent processing and testing for PD-L1 alongside analyses for histologic subtype and other standard prognostic biomarkers1
  • An assessment of PD-L1 levels at this stage may aid identification of patients with likelihood of a response to PD-1/PD-L1 monotherapy or combination therapy;2,3 this outcome at diagnosis could remain predictive of response across all lines of therapy4
  • If PD-L1 testing was not performed at diagnosis of metastatic bladder cancer, testing following disease progression, prior to initiation of second-line and later treatment, is also appropriate
    • Tumour samples obtained at diagnosis and appropriately processed and archived can undergo PD-L1 testing at this stage to aid identification of patients more likely to respond to second-line PD-1/PD-L1 monotherapy/combination therapy5–9
    • Based on an analysis of NSCLC biopsies (<3 months to >3 years), repeat biopsy may not be required to assess PD-L1 levels following disease progression9

PD-1, programmed cell death-1; PD-L1, programmed cell death ligand-1; SoC, standard of care; NSCLC, non-small cell lung cancer

REFERENCES

  1. NCCN Guidelines Version 2.2017. Bladder Cancer. Available at:
    https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. Last accessed March 2017
  2. Hellmann DM, et al. Oral presentation at ASCO 2016 (abstract 3001)
  3. Garon EB, et al. N Engl J Med 2015;372:2018–28
  4. Rizvi NA, et al. Poster presented at ASCO 2015 (abstract 8032)
  5. Borghaei H, et al. N Engl J Med 2015;373:1627–39
  6. Antonia S, et al. Lancet Oncol 2016;17:299–308
  7. Rosenberg JE, et al. Lancet 2016;387:1909–20
  8. Herbst RS, et al. Lancet 2016;387:1540–50
  9. Midha A, et al. Poster presented at ASCO 2016 (abstract 3025)

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