Biomarkers to guide immunomodulatory treatment: where do we stand?

Expert Rev Mol Diagn. 2023 Sep 10. doi: 10.1080/14737159.2023.2258063. Online ahead of print.ABSTRACTINTRODUCTION: This review summarizes current progress in the development of biomarkers to guide immunotherapy in oncology, rheumatology and critical illness.AREAS COVERED: An extensive literature search was performed about biomarkers classifying patients' immune responses to guide immunotherapy in oncology, rheumatology and critical illness. Surface markers, such as programmed death-ligand 1 (PD-L1), genetic biomarkers, such as tumor mutation load, and circulating tumor DNA are biomarkers associated with the effectiveness of immunotherapy in oncology. Genomics, metabolomics and proteomics play a crucial role in selecting the most suitable therapeutic options for rheumatologic patients. Phenotypes and endotypes are a promising approach to detect critically ill patients with hyper- or hypo-inflammation. Sepsis trials using biomarkers such as ferritin, lymphopenia, HLA-DR expression on monocytes and PD-L1 to guide immunotherapy, have been already conducted or are currently ongoing. Immunotherapy in COVID-19 pneumonia, guided by C-reactive protein and soluble urokinase plasminogen activator receptor (suPAR) has improved patient outcomes globally. More research is needed into immunotherapy in other critical conditions.EXPERT OPINION: Targeted immunotherapy has improved outcomes in oncology and rheumatology, paving the way for precision medicine in the critically ill. Transcriptomic...
Source: Expert Review of Molecular Diagnostics - Category: Laboratory Medicine Authors: Source Type: research