FIRST-LINE TREATMENT WITH PEMBROLIZUMAB PLUS CHEMOTHERAPY IN ADVANCED NON-SMALL CELL LUNG CANCER WITHOUT TUMOR PD-L1 EXPRESSION

Abstract

Some tumors produce a protein called programmed death ligand 1 (PD-L1), which interacts with the body’s immune cells and prevents an immune response against cancer. Immune checkpoint inhibitors such as pembrolizumab binds to the programmed cell death protein-1 (PD-1) receptor, blocks its interaction with ligands PD-L1 and PD-L2 and enables an immune response. Pembrolizumab is the first PD-1 inhibitor, approved for advanced or metastatic non small cell lung cancer (NSCLC) monotherapy for patients with tumors that produce high PD-L1 level. However, when it is combined with chemotherapy, which can stimulate anticancer immune responses, pembrolizumab provides a benefit, regardless of tumor PD-L1 production. In clinical trials pembrolizumab plus chemotherapy demonstrated response and survival improvements in comparison with chemotherapy alone in PD-L1‒negative advanced or metastatic NSCLC, and it is a standard-of care first-line therapy for patients with advanced NSCLC, regardless of PD-L1 expression.