4.5 Article

Biomarkers to guide immunomodulatory treatment: where do we stand?

Journal

EXPERT REVIEW OF MOLECULAR DIAGNOSTICS
Volume -, Issue -, Pages -

Publisher

TAYLOR & FRANCIS AS
DOI: 10.1080/14737159.2023.2258063

Keywords

Sepsis; COVID-19; rheumatic disease; cancer; immunomodulation; immunotherapy; biomarker

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This review summarizes the current progress in the development of biomarkers to guide immunotherapy in oncology, rheumatology, and critical illness.
Introduction: 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. Transcriptomics will play a crucial role in detecting the most suitable candidates for immunomodulation.

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