Biopsy and re-biopsy for PD-L1 expression in NSCLC. association between PD-L1 and checkpoint inhibitor efficacy through treatment in NSCLC. A pilot study

Expert Rev Respir Med. 2021 Nov;15(11):1483-1491. doi: 10.1080/17476348.2021.1987888. Epub 2021 Oct 12.


Introduction: Lung cancer is diagnosed at a late stage due to lack of early disease symptoms. Therefore an efficient treatment is necessary for prolonged disease free survival.

Patients and methods: In our study we recruited 124 patients NSCLC patients with adenocarcinoma and squamus cell carcinoma. All recuited patients had Programmed death-ligand 1 expression ≥50 (PD-L1)with DAKO technique. Immunotherapy was administered with as first line treatment. Re-biopsies were performed in the main lung lesion every 4 months with the restaging of the patient and also in the metastastic sites in other organs that occurred during treatment. PD-L1 expressed was evaluated in the biopsies of the metastatic sites.

Results: It appears thereafter that the PD-L1 expression could easily be claimed as a promising bio-index with a cutoff value 65, below which a negative prognosis of the disease progress will be evident and above that value a positive continuation of the disease will be prominent.

Conclusion: The findings of this study suggest that the PD-L1-65 index works adequately either concerning the neo-metastatic sites or the patient disease responses. Re-biopsies in new metastastic sites are necessary since we probably have a new cancer and chemotherapy should be added. More studies should confirm are results and change the NSCLC treatment approach of these patients.

Keywords: DAKO; EBUS; NSCLC; PD-L1; adenocarcinoma; biopsy; re-biopsy; squamus; survival.

MeSH terms

  • B7-H1 Antigen*
  • Biopsy
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors*
  • Lung Neoplasms* / drug therapy
  • Pilot Projects


  • B7-H1 Antigen
  • CD274 protein, human
  • Immune Checkpoint Inhibitors