Biomarker in Liquid Biopsy for Lung Cancer Appears More Accurate in Predicting Immunotherapy Response Than Tumor Biopsy
Study findings could be developed into less-invasive method
Mount Sinai researchers have validated for the first time that a simple blood test called a liquid biopsy could be a better predictor of whether cancer immunotherapy will be successful for a patient with lung cancer than an invasive tumor biopsy procedure. Their study was published in the Journal of Experimental & Clinical Cancer Research in June.
The liquid biopsy tests for a biomarker of PD-L1, a protein and target for a type of immunotherapy called checkpoint inhibitors, which helps the patient’s immune system attack and kill cancer cells. This study showed that testing the blood of lung cancer patients for the PD-L1 biomarker gave more accurate predictions of the response and survival for patients with lung cancer than testing for PD-L1 in tissue from lung cancer biopsies, the current standard of care.
The biomarker in blood, named EV PD-L1, comes from extracellular vesicles, which are particles shed from tumor cells. A decrease of PD-L1 in extracellular vesicles in blood could therefore become a useful test to predict which patients with non-small-cell lung cancer could benefit from immunotherapy.
“These results will have an impact in the search for biomarkers to predict for immunotherapy outcome in patients with lung cancer as no truly reliable biomarkers have been found yet,” said senior author Christian Rolfo, MD, PhD, MBA, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai, Associate Director for Clinical Research in the Center for Thoracic Oncology at The Tisch Cancer Institute, and President of the International Society of Liquid Biopsy. “If validated in larger prospective cohorts of patients, as we are working on now, this protein could complement or substitute for the tissue PD-L1 as the standard of care in these and other types of tumor patients receiving immunotherapy, especially because it is minimally invasive and can be repetitive during treatment, being able to detect changes in the tumor during the treatment in real time.”
Researchers collected blood samples from two cohorts of 33 and 24 patients with non-small-cell lung cancer receiving immune-checkpoint inhibitors before and at the ninth week of treatment. They also included a group of 15 patients receiving chemotherapy as controls. Extracellular vesicles were isolated from blood samples and the protein expression of PD-L1 was measured in each group at both time points. Researchers also measured imaging scans of patients’ tumors before treatment and evaluated them with an innovative imaging technology called radiomics to create a full model for prediction of immunotherapy response.
This study, led by Dr. Rolfo, included collaboration of experts in radiomics and medical oncology from the United States, Mexico, and Italy.
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Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.