A new frontier for targeted therapy in NSCLC: clinical efficacy of pembrolizumab in the inhibition of programmed cell death 1 (PD-1)

Abstract

Non-small-cell lung cancer (NSCLC) is the main pathological type among lung cancers, and it is often diagnosed at an advanced stage of the disease when it is no longer amenable to curative treatments. During recent decades, the survival rate for lung cancer patients has improved significantly in only those whose tumours harbour a driver mutation. Immune checkpoint inhibition is a promising therapeutic strategy for lung cancer. The Keynote 024 is randomized, open-label, international, phase III study to evaluate the efficacy of pembrolizumab, an antibody directed to programmed death 1 (PD-1), an immune checkpoint inhibitor, compared with platinum-based chemotherapy in patients with previously untreated advanced NSCLC and PD-L1 expression in at least 50% of the tumour cells. Pembrolizumab treatment achieved statistically significant clinical benefits in terms of progression free survival, overall survival and objective responses. The high quality of data and the novelty of the information obtained created the conditions for a new standard of care driven by the expression of PD-L1.

Keywords: PD-L1; Pembrolizumab; brain metastasis; immunotherapy; non-small-cell lung cancer; platinum-based chemotherapy; quality of life; squamous histotype.