Programmed death ligand-1 (PD-L1) immunohistochemistry is a prevalent immunotherapy biomarker. Huang et al. examined the prevalence of PD-L1 expression across tumor types and in relation to microsatellite instability, tumor mutational burden (TMB), and CD274 (PD-L1) gene amplification. They identified PD-L1 expression more frequently in immune cells rather than in tumor cells. There was a high correlation between PD-L1 expression and CD274 gene amplification and the combination of PD-L1 and TMB with varying prevalence in different tumor types. To date, this study of 48,000 cases is the largest pan-cancer analysis of combined biomarkers associated with checkpoint inhibitors. It has guided the proposal for additional clinical trials to determine whether patients with double-positive PD-L1 + /TMB + would have the best response to immunotherapy.
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