Pembrolizumab, an inhibitor target programmed death 1 (PD-1), was approved into the first line therapy in advanced non-small cell lung cancer (NSCLC). It was a milestone that immune checkpoints drugs have played an important role in the treatment system of NSCLC. The results of clinical trials revealed the superiority of PD-1/programmed death ligand 1 (PD-L1) inhibitors compared with chemotherapy in first-line, second-line and multidrug resistance phase therapy. Objective response rate (ORR) was up to 80% with pembrolizumab plus chemotherapy, and progression-free survival (PFS) with single pembrolizumab in first line was nearly 1 year (10.3 months), the hazard ratio for death fell by 40%. Overall survival (OS) was more or less 1 year with single drug pembrolizumab, nivolumab and atezolizumab for second line therapy. PD-L1 expression was a predictor of PD-1/PD-L1 inhibitors. The positive rate of PD-L1 (more than 1%) in advanced NSCLC was about 60% with little difference between the tissue types. However, there was no gold standard test of PD-L1 expression.
程序性死亡受体1（programmed death 1, PD-1）抑制剂Pembrolizumab进入一线正式标志着免疫检查点抑制剂在晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）的治疗体系中占据了重要地位。临床试验结果证实PD-1/程序性死亡配体1（programmed death ligand 1, PD-L1）抑制剂在晚期NSCLC的一线、二线和多药耐药后治疗的疗效均要优于传统的化疗。一线使用Pembrolizumab联合化疗的客观有效率（objective response rate, ORR）最高可达80%；单药Pembrolizumab的无疾病进展时间（progression-free survival, PFS）接近1年（10.3个月），死亡风险比含铂双药化疗下降40%。单药Pembrolizumab、Nivolumab和Atezolizumab用于二线的疗效同样突出，总生存时间（overall survival, OS）可至1年左右。PD-L1的表达是PD-1/PD-L1抑制剂疗效的预测因子，在晚期NSCLC中阳性（≥1%）的比例约为60%左右，组织类型间差异不大，但是目前并无检测的金标准。.