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Biomarkers For Predicting Checkpoint Inhibitor Response

Biomarkers For Predicting Checkpoint Inhibitor Response
Biomarkers For Predicting Checkpoint Inhibitor Response
Lab Medicine

As the biomarkers associating with the higher diagnosis for predicting the accurate responce to an anti-programmed cell death. But in this study the showing the different types of the biomarkers like interferon-gamma gene signature, and protien biomarkers. PD-L1 (programmed cell death ligand 1) immunohistochemistry (IHC), tumor mutational burden (TMB), gene expression profiling (GEP), and multiplex immunohistochemistry/immunofluorescence (mIHC/IF) assays have been used to assess pretreatment tumor tissue to predict response to anti-PD-1/PD-L1 therapies.

However, the relative diagnostic performance of these modalities has yet to be established. these results could vary by tumor type, and as more studies become available, this aspect should be investigated. s that two of the most widely used biomarkers in current practice – PD-L1 immunohistochemistry (PD-L1IHC) and TMB – did not differ significantly in their ability to predict response to anti-PD-L1 immunotherapy.

Checkpoint inhibitor response

But the studies that examining the use of PD-L1IHC, TMB, gene expression profiling (GEP), and mIHC/IF assays to determine objective response to anti-PD-1/PD-L1 therapy. For PD-L1 IHC, only clinical trials that resulted in US Food and Drug Administration approval of indications for anti-PD-1/PD-L1 were including. Outcome measures for each assay modality included summary receiver operating characteristic (sROC) curves; their associated area under the curve (AUC); and pooled sensitivity, specificity, positive and negative predictive values (PPV, NPV), and positive and negative likelihood ratios (LR+ and LR−).

When each modality was evaluating with sROC curves, mIHC/IF had a significantly higher AUC (0.79) comparing with PD-L1 IHC (0.65), GEP (0.65,), and TMB (0.69). All modalities demonstrated comparable NPV and LR−; however, mIHC/IF demonstrated higher PPV (0.63) and LR+ (2.86) than the other approaches.

Primary statistical analysis

An in-depth analysis of the studies that supported this publication would show that the fewest number of patients studied had their tumors tested using the same technology; that is purporting to have a slight advantage. The authors do point out that the primary statistical analysis of ‘area under the curve’ for this meta-analysis; was weighting by number of patients studying for each methodology. Given that thousands of patients have been tested by PD-L1 IHC, which was inferior to multiplex IHC/immunofluorescence; where less than a few hundred patients have been studied; it will be interesting to see if this observation holds up with further study.

This study very likely reflects the general phenomenon; that studies with low power have a larger chance of having a larger effect size than studies with high power;  For PD-L1 IHC, only clinical trials that resulted in US Food and Drug Administration approval of indications; for anti–PD-1/PD-L1 were including. Studies combining more than 1 modality were also including. Preferring Reporting Items for Systematic Reviews and Meta-analysis guidelines were following.