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Review
. 2018 Jul 7;24(25):2686-2697.
doi: 10.3748/wjg.v24.i25.2686.

Advances in immuno-oncology biomarkers for gastroesophageal cancer: Programmed death ligand 1, microsatellite instability, and beyond

Emily M Lin  1 , Jun Gong  2 , Samuel J Klempner  3 , Joseph Chao  4
Affiliations
Review

Advances in immuno-oncology biomarkers for gastroesophageal cancer: Programmed death ligand 1, microsatellite instability, and beyond

Emily M Lin et al. World J Gastroenterol. .

Abstract

Blockade of the programmed death ligand 1 (PD-L1) and programmed cell death 1 (PD-1) receptor axis represents an effective form of cancer immunotherapy. Preclinical evidence initially suggested that gastric and gastroesophageal junction (GEJ) cancers are potentially immunotherapy-sensitive tumors. Early phase clinical trials have demonstrated promising antitumor activity with PD-1/PD-L1 blockade in advanced or metastatic gastric/GEJ cancer. Microsatellite instability (MSI) and PD-L1 expression have been shown to predict higher response to PD-1 inhibitors as highlighted by the recent approvals of pembrolizumab in treatment-refractory solid tumors with MSI status and the third-line or greater treatment of PD-L1 positive advanced gastric/GEJ cancers. However, predictive and prognostic biomarkers remain an ongoing need. In this review, we detail the preclinical evidence and early tissue biomarker analyses illustrating potential predictive biomarkers to PD-1/PD-L1 blockade in gastric/GEJ cancer. We also review the clinical development of PD-1/PD-L1 inhibitors in gastric/GEJ cancer and highlight several areas in need of future investigation in order to optimize the efficacy of PD-1/PD-L1 blockade in gastric/GEJ cancer.

Keywords: Gastric cancer; Immunotherapy; Microsatellite instablility; Programmed cell death 1; Programmed death ligand 1.

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Conflict of interest statement

Conflict-of-interest statement: Chao J has received research support (institutional), consulting, and speaker fees from Merck; Klempner SJ has received research support from Leap Therapeutics and Astellas (institutional), and consulting fees from Boston Biomedical and Lilly Oncology. The remaining authors declare no conflicts of interest.

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