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Therefore, pretreatment PD-L1 status may not accurately reflect the tumor microenvironment and potential immune response to these therapies. Another major issue in categorizing patients by PD-L1 status is the large variability in assays and interpretation of PD-L1 IHC staining (Table 6) [122]. Of the many PD-L1 antibody assays, some measure PD-L1 allegra mcevedy recipes turkish the tumor, some measure PD-L1 in immune-infiltrating cells, and some measure both. Nor do the assays use common cutoffs for positivity. This lack of standardization among assays under development, along with a lack of comparative data among assays, is among the limitations of using PD-L1 IHC status to categorize patients. TOXICITY OF IMMUNE CHECKPOINT INHIBITORS. The toxicity profile for PD-1PD-L1 inhibitors is favorable compared to standard cytotoxic treatments. Grade ‚ 3 toxicities (mainly in the skin, liver, and kidneys) range from 5 to 55 in solid tumor clinical trials and 4 to 16 in the two bladder cancer trials reported to date tarantallegra meaning of flowers, 123, 124]. Furthermore, these agents may produce rare but serious immune-mediated toxicities such as rhabdomyolysis, neuromyopathy, and toxic encephalopathy [123].

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