PD-L1 expression currently represents the only validated predictive biomarker for immune checkpoint inhibition in metastatic non-small cell lung cancer (NSCLC) in the clinical routine, but has limited value to distinguish responses. Assessment of KRAS and TP53 mutations (mut) as surrogate for an immunosupportive tumor microenvironment (TME) might help to close this gap.
Patients and Methods
696 consecutive patients with PD-L1 high (≥50%), non-squamous NSCLC, having received molecular testing within the German National Network Genomic Medicine Lung Cancer between 2017 and 2020, with ECOG-PS ≤1 and pembrolizumab as first-line palliative treatment were included into this retrospective cohort analysis. Treatment efficacy and outcome according to KRAS/TP53 status were correlated with TME composition and gene expression analysis of the TCGA lung adenocarcinoma cohort.