%0 Journal Article
%T Is an immune checkpoint inhibitor really a hopeless therapeutic choice for EGFR-mutant non-small cell lung cancer (NSCLC) patients?
%A Kazumi Nishino
%A Kei Kunimasa
%A Toru Kumagai
%J Archive of "Annals of Translational Medicine".
%D 2019
%R 10.21037/atm.2019.02.18
%X The treatment strategy of lung cancer with chemotherapy is changing rapidly owing to developments in the characterization of non-small cell lung cancer (NSCLC) genetic profiles and identification of hallmark immunological characteristics (1). Indeed, this represents a time of unprecedented changes occurring within a short period. These advances in knowledge and technologies have led to the development of several targeted therapies and immune checkpoint inhibitors directed against tumor molecules, which also serve as therapeutic biomarkers. Currently available clinical routine biomarkers guiding the treatment of patients with NSCLC include epidermal growth factor receptor (EGFR) mutations, the T790M EGFR resistance mutation, anaplastic lymphoma kinase (ALK) fusion gene status, ROS1 fusion gene status, EGFR expression, and programmed death-ligand 1 (PD-L1) expression (2). However, implementation of these molecular biomarkers in clinical practice remains challenging, and the application of genomic and immunological biomarkers in routine clinical practice has raised several concerns that have yet to be resolved by the large clinical studies conducted to date. These questions include: What is the overlap of a PD-L1 tumor proportion score (TPS) of at least 50% with the conccurent targetable driver oncogenic mutations? How should one select the appropriate 1st line chemotherapy on the basis of the biomarker profile? In this commentary, we focus on the treatment strategy for EGFR-mutant NSCLC patients with high PD-L1 expression
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462634/