That may be true for moderate levels of genetic instability but SCLC is extraordinary in this regard; enough so that there's a virtual guarantee that somewhere in the tumor cell population there are going to be some cells that can escape PD-1/PD-L1 inhibition.
I just realized that the new NCCN SCLC guidelines that came out yesterday are recommending Genentech's anti-PD-L1 in the first-line setting for SCLC. Maybe targeting PD-L1 is more effective than targeting PD-1? If you were to ask me in the absence of any other data I would say that the opposite would be more effective.
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