HLA presents cellular peptides and engages T-cell receptors (TCR) to activate T cells and to induce an immune response to foreign tissue, pathogens or abnormal antigens. Genomic human leukocyte antigen (HLA) has an important role in the activation process of the immune system. Those can be used to guide selection of the appropriate therapy for each patient based on the likelihood of clinical benefit while minimising the risk of developing adverse events. Therefore, research exploring additional biomarkers that might add value to PD-L1 TPS or be used as an alternative is necessary. Additionally, there are no biomarkers approved for clinical use to predict the development of immune related adverse events (irAEs). In particular, patients with PD-L1 TPS of less than 1% or low TMB still derive benefit from the immunotherapy and some with high PD-L1 expression ( > 50%) or high TMB will not respond to anti-PD-L1/ PD1 therapies. Currently, the programmed death ligand -1 (PD-L1) tumour proportion score (TPS) and tumour mutation burden (TMB) are the only Food and Drug Administration (FDA) approved biomarkers that identify patients with NSCLC who will benefit the most from anti-PD1/PD-L1 therapy. However, the majority of patients do not derive clinical benefit from immunotherapy and the adverse events associated with this treatment remains challenging, not only due to the significant morbidity that impairs patients’ quality of life but also the additional financial burden on the health system. ![]() Immunotherapy has revolutionised the treatment of advanced non-small cell lung cancer (NSCLC) and resulted in a higher response rate, and improved overall survival, with some deriving durable long-term benefits.
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