Bartelds, Boudewijn (2026) Predictive Value and Limitations of Biomarkers for PD-1/PD-L1 Checkpoint Inhibitor Therapy in Non–Small Cell Lung Cancer. Bachelor's Thesis, Biology.
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Abstract
Immune checkpoint inhibitor therapy targeting the PD-1/PD-L1 pathway have significantly improved outcomes for a subset of patients with advanced non-small cell lung cancer (NSCLC). However, only a minority of patients derive durable benefit, while treatment is associated with substantial toxicity and cost. Reliable predictive biomarkers are therefore essential to optimize patient selection. PD-L1 expression is the most used biomarker and enriches for responders, particularly at high expression levels, but demonstrates limited sensitivity and specificity due to biological heterogeneity and assay variability. TMB reflects tumor mutational load and potential neoantigen generation but shows inconsistent predictive performance and is confounded by factors such as smoking status and immune activation. MSI is a strong predictor of response to PD-1 blockade but occurs rarely in NSCLC, limiting its clinical utility. Circulating biomarkers, particularly dynamic changes in ctDNA during treatment, are strongly associated with clinical outcomes but primarily reflect treatment response rather than baseline sensitivity. No single biomarker reliably predicts response to PD-1/PD-L1 therapy in NSCLC. Evidence supports a shift toward integrated biomarker strategies that combine tumor immune contexture, antigen presentation capacity, and dynamic response monitoring. Prospective validation of such multidimensional approaches is required to improve patient selection and clinical outcomes.
| Item Type: | Thesis (Bachelor's Thesis) |
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| Supervisor name: | Bogaart, G. van den |
| Degree programme: | Biology |
| Thesis type: | Bachelor's Thesis |
| Language: | English |
| Date Deposited: | 21 Jan 2026 09:58 |
| Last Modified: | 21 Jan 2026 09:58 |
| URI: | https://fse.studenttheses.ub.rug.nl/id/eprint/37214 |
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