[Progress of PD-1/PD-L1 Inhibitors in Non-small Cell Lung Cancer]

Area of Science:

• Oncology
• Immunology
• Pulmonology

Background:

• Immune checkpoint inhibitors targeting programmed death 1 (PD-1) have emerged as a significant advancement in non-small cell lung cancer (NSCLC) therapy.
• Pembrolizumab is approved for first-line treatment of advanced NSCLC, marking a milestone in integrating immunotherapy into cancer care.

Purpose of the Study:

• To evaluate the efficacy and role of PD-1/PD-L1 inhibitors in various treatment settings for advanced NSCLC.
• To assess the predictive value of PD-L1 expression for response to PD-1/PD-L1 inhibitors.

Main Methods:

• Review of clinical trial data comparing PD-1/PD-L1 inhibitors with chemotherapy in first-line, second-line, and multidrug-resistant advanced NSCLC.
• Analysis of objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) data.
• Examination of PD-L1 expression as a predictive biomarker.

Main Results:

• PD-1/PD-L1 inhibitors demonstrate superiority over chemotherapy in multiple NSCLC treatment lines.
• Pembrolizumab plus chemotherapy achieved an ORR up to 80%; single-agent pembrolizumab showed a PFS of 10.3 months in the first line, reducing the hazard ratio for death by 40%.
• Second-line therapies with single agents like pembrolizumab, nivolumab, and atezolizumab resulted in OS of approximately 1 year. PD-L1 expression (≥1%) is observed in about 60% of advanced NSCLC cases but lacks a standardized testing method.

Conclusions:

• PD-1/PD-L1 inhibitors represent a superior treatment option compared to chemotherapy for advanced NSCLC across different lines of therapy.
• PD-L1 expression is a key predictive biomarker for response to these immunotherapies, although standardization of testing remains a challenge.
• The integration of immune checkpoint inhibitors has fundamentally changed the treatment landscape for advanced NSCLC, offering improved survival and response rates.