NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer

38 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 PD-L1 expression T cells are part of your body’s disease-fighting (immune) system. One job of T cells is to attack cancer cells. Some lung cancers consist of cells that make (express) molecules called PD-L1. PD-L1 attaches to PD-1 on T cells and stops them from attacking cancer cells. See Figure 13 . Pembrolizumab, nivolumab, durvalumab, and atezolizumab are medicines that block PD-L1 from attaching to T cells. Testing for PD-L1 expression is advised for all types of metastatic lung cancer. Results may be used to decide which treatment is best. It is required before use of pembrolizumab. Other biomarkers There are other known biomarkers linked with NSCLC. However, they are rare and related treatments are still being tested in clinical trials. Testing for these biomarkers should be done along with EGFR , ALK , and ROS1 testing. There may be treatments available or a clinical trial you could join. Read Part 5 for more information on clinical trials. Other gene changes linked with lung cancer include: † † High-level MET amplification, † † MET exon 14 skipping mutation, † † RET gene rearrangements, and † † HER2 mutations. 4 Treatment planning Cancer lab tests Figure 13 PD-L1 expression Some lung cancers consist of cells with PD-L1. PD-L1 attaches to a receptor on a T cell called PD-1. When attached, PD-L1 stops the T cell from attacking the cancer cell. cancer cell T cell PD-L1 PD-1 Copyright © 2017 National Comprehensive Cancer Network ® (NCCN ® ).