Quick Facts
- PD-L1/2 testing crucial for personalized lung cancer treatment, especially in advanced non-small cell lung cancer (NSCLC).
- A high PD-L1/2 expression indicates likely success with immunotherapy.
- Testing helps tailor treatment specifically for your cancer’s characteristics.
Molecular testing is taking center stage in the treatment of lung cancer. It’s helping to make cancer treatment more personal — and more effective.
Read MoreWhat is PD-L1/2 testing?
PD-L1/2 testing is a type of molecular testing that looks at the expression of PD-L1 and PD-L2 proteins on the surface of lung cancer cells. These are proteins that can help the cancer cells avoid being attacked by the immune system. Some immunotherapy drugs, called checkpoint inhibitors, can block the interaction between PD-L1/2 and their receptors on immune cells, and restore the immune response against the cancer.PD-L1/2 testing can help determine if a patient is likely to benefit from these drugs, as higher expression of PD-L1/2 may indicate a better response.
PD-L1/2 testing can be done on a biopsy sample of the tumor, using different methods such as immunohistochemistry (IHC) or in situ hybridization (ISH).
Doctors will usually recommend PD-L1/2 testing for patients with advanced non-small cell lung cancer (NSCLC) who are considering immunotherapy as a treatment option.
“The cancer cells are so smart that they understand that our immune system cells have brakes on them.,” Dr. Mohamed Mohamed, a thoracic medical oncologist at Cone Health Cancer Center in Greensboro explains to SurivorNet. “The cancer cells secrete a protein called PD-L1 or PD-L2 to go and attach to [those] brakes. They, [therefore], stop the immune cells from attacking the cancer.”
How is PD-L1/2 testing performed?
PD-L1/2 testing involves analyzing a lung tumor tissue sample, obtained in one of two ways:
- During tumor removal surgery, a small piece of the tumor is collected.
- If surgery is not an option, a biopsy is performed, where a needle extracts a small tissue sample.
Either way, the sample is sent to a specialized lab for PD-L1 and PD-L2 protein examination on cancer and surrounding immune cells. You will usually get test results back within a week. They will be categorized as follows:
- High PD-L1/2 expression: Indicates a stronger immune response, likely leading to positive outcomes with immunotherapy.
- Low PD-L1/2 expression: Suggests a weaker immune response, indicating that alternative treatments targeting cancer cells directly may be the best course of treatment.
- Borderline or unclear PD-L1/2 levels: This result requires discussion with your doctor to weigh the treatment option risks and benefits.
RELATED: Lung Cancer: Overview
Who should have PD-L1/2 testing?
PD-L1/2 testing is crucial for patients with advanced non-small cell lung cancer (NSCLC) considering immunotherapy.
Certain immunotherapy drugs, known as checkpoint inhibitors, work by blocking PD-L1/2 from interacting with receptors on immune cells. This action revs up the immune system’s response against cancer.
The level of PD-L1/2 expression can be a key indicator of how well you might respond to these drugs. Higher expression typically suggests a more favorable reaction to immunotherapy.
Getting this type of testing can help you and your doctor come up with a personalized treatment pl to ensure you get the therapies best suited to your cancer’s specific characteristics.
RELATED: What Is PD-L1 Testing In Lung Cancer And Why Does It Matter?
How does PD-L1/2 testing fit into an overall treatment plan?
PD-L1/2 testing can play an important role in the overall treatment planning for lung cancer, particularly NSCLC.
- Personalized treatment planning can help your doctors tailor treatment to the specific characteristics of a patient’s cancer.
- High PD-L1/2 expression in tumor cells suggests you will respond well to immunotherapies, specifically checkpoint inhibitors.
- PD-L1/2 testing is often used along with other diagnostic methods, like genetic profiling to gain a more complete understanding of your cancer.
- PD-L1/2 testing in lung cancer is becoming increasingly important in identifying patients who could benefit from newer, more targeted treatments.
Questions to ask your doctor:
If you are considering PD-L1/2 testing, discuss what that means with your doctor. Questions you may want to ask:
- Has my lung cancer been tested for PD-L1/2?
- What did my PD-L1/2 testing show?
- Do my results make me eligible for targeted drugs that could improve my treatment outcomes?
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