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Goodbye PD-L1?

Discussion in 'Pathology' started by WEBB PINKERTON, May 25, 2017.

  1. WEBB PINKERTON

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    Is PD-L1 testing going to be a thing of the past with new FDA approval for Keytruda that just came out?
     
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  3. pathslides

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    Oncologists will just ask for MSI testing on everything now.
     
    Autopsy101 likes this.
  4. coroner

    coroner Peace Sells...but who's buying?
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    PD-L1 testing is here to stay regardless of FDA approval of Keytruda for multiple reasons:

    1) It’s still part of the NCCN guidelines for squamous cell carcinoma of the lung

    2) It’s almost always the first test ordered for NSCLC w/ or w/o EGFR vs ALK, and ROS.

    3) Different assays for PD-L1 can affect the type of immunotherapy given e.g. Keytruda vs Tecentriq.

    4) Clinicians are still going to want all info available at their disposal

    Not to mention, it’s a valid test we can interpret and bill for, sort of like when everybody started doing HER-2. So pathologists will be more than happy to continue to do so with PD-L1.
     
    #3 coroner, Jun 29, 2017
    Last edited: Jun 29, 2017
    medgator likes this.
  5. coroner

    coroner Peace Sells...but who's buying?
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    You may have a point though. Although I still think PD-L1 will still be used, with the FDA approval of Keytruda, the reimbursement rates of this expensive treatment no longer hinges on PD-L1 testing because it is now a complementary test instead of a companion test. So, testing it could either stabilize or possibly decrease, but such changes probably won't become evident for another few years. Not sure what the future holds...
     
  6. WEBB PINKERTON

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    If we weren't playing with monopoly money, it would decrease. We all see overkill on a daily basis in medicine so look for testing to stabilize or increase. The vendors and labs have to keep the machine fed so there can't be a reduction in demand.
     

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