CSI Laboratories offers PD-L1 testing which aids in identifying patients whose tumor cells or tumor infiltrating immune cells are expressing PD-L1. This testing subsequently assists in the selection of patients who may be appropriate candidates for several anti-PD-L1/anti-PD-1 immunotherapies.
In the “first-line setting,” patients with low or negative PD-L1 expression who also test negative for an EGFR mutation or an ALK or ROS1 rearrangement should receive standard chemotherapy — not immunotherapy. However, in the “second-line setting,” patients exhibiting low or unknown PD-L1 expression can be given standard chemotherapy, nivolumab immunotherapy, or atezolizumab immunotherapy.
Additional details on the update to the ASCO Guidelines for Stage IV NSCLC can be found here: ASCO Guidelines Update