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The FDA has approved the immune checkpoint inhibitor pembrolizumab (Keytruda – Merck), a programmed death receptor-1 (PD-1) inhibitor, for first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) that highly expresses programmed death-ligand 1 (PD-L1) and has no epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) translocations. About 25% of patients with advanced NSCLC have tumors with high levels of PD-L1 expression (PD-L1 expressed on ≥50% of tumor cells). Pembrolizumab was approved earlier for treatment of metastatic NSCLC with PD-L1 expression ≥1% that progressed on or after platinum-based chemotherapy.1
MECHANISM OF ACTION — PD-1 is an inhibitory receptor expressed by T-cells during long-term antigen exposure. Activation of PD-1 by its ligands (PD-L1 and PD-L2) inhibits T-cell proliferation and... more
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