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Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing
Published on: October 10, 2025
New PDL1 inhibitors for non-small cell lung cancer: focus on pembrolizumab
Olivier Bylicki1, Nicolas Paleiron2, Gaëlle Rousseau-Bussac3
1Pneumology Department, Hôpital d'Instruction des Armées Percy, Paris, bylicki.olivier@yahoo.fr.
Abstract:
The advent of immune-checkpoint inhibitors during the past decade represents a major advancement in the treatment of non-small cell lung cancer (NSCLC) with personalized treatment. Platinum-based chemotherapy has reached its efficacy threshold, with its use remaining limited by its toxicity. For NSCLC, inhibitors of the PD1 protein and its ligand PDL1 show promising clinical activity and induce durable responses in patients with advanced disease. The US Food and Drug Administration has approved pembrolizumab for treatment-naïve metastatic NSCLC with ≥50% of tumor cells expressing PDL1 and for metastatic NSCLC with ≥1% PDL1 expression after progression following first-line platinum-based doublet chemotherapy. In 2017, it also authorized the first-line combination of pembrolizumab and carboplatin-pemetrexed chemotherapy without selection based on PDL1 expression, but European health authorities are still waiting for the results of a Phase III trial. In this review, the clinical results of published and ongoing studies evaluating pembrolizumab for advanced NSCLC are analyzed and the potential role of PDL1 as a factor predictive of overall responses addressed.
Insights
Immune-checkpoint inhibitors like pembrolizumab offer new hope for advanced non-small cell lung cancer (NSCLC). These therapies, targeting PD1/PDL1, show promising activity and durable responses in patients with NSCLC.
Area of Science:
- Oncology
- Immunotherapy
- Personalized Medicine
Background:
- Platinum-based chemotherapy for non-small cell lung cancer (NSCLC) has limitations due to toxicity and plateaued efficacy.
- Immune-checkpoint inhibitors targeting PD1 and PDL1 have emerged as a significant advancement in NSCLC treatment.
Purpose of the Study:
- To review the clinical results of studies evaluating pembrolizumab in advanced NSCLC.
- To assess the potential of PDL1 as a predictive biomarker for treatment response.
Main Methods:
- Analysis of published and ongoing clinical studies on pembrolizumab for advanced NSCLC.
- Evaluation of PDL1 expression as a predictive factor for overall response.
Main Results:
- Pembrolizumab demonstrates promising clinical activity and durable responses in advanced NSCLC.
- Regulatory approvals exist for pembrolizumab in specific NSCLC patient populations based on PDL1 expression.
- Combination therapy with pembrolizumab and chemotherapy is being investigated.
Conclusions:
- Immune-checkpoint inhibitors, particularly pembrolizumab, represent a major advancement in NSCLC treatment.
- PDL1 expression is a key factor in patient selection for pembrolizumab therapy.
- Further research is ongoing to optimize the use of pembrolizumab in NSCLC.
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