Novel treatment strategies incorporating PD-1/PD-L1 inhibitors in the first-line setting of advanced non-small-cell lung cancer (NSCLC) provided relevant improvements in survival outcomes. Among NSCLC patients with PD-L1 tumor proportion score ≥50%, identifying the ones to be addressed to pembrolizumab monotherapy or chemo-immunotherapy combinations is a matter of debate, taking into account the risks of overtreatment and toxicity. Here we report the clinical stories of four NSCLC patients with PD-L1 tumor proportion score ≥50% and good performance status, sharing high tumor burden including serosal involvement. After having rapidly progressed on first-line PD-1/PD-L1 inhibitors, they achieved major clinical and radiological response to pembrolizumab-chemotherapy combination. These cases prove the feasibility and effectiveness of salvage chemo-immunotherapy in pembrolizumab-refractory NSCLC patients.
PD-L1 ≥ 50% lung cancer refractory to PD-1 inhibition: The role of salvage chemo-immunotherapy combination / Gelsomino, F.; Facchinetti, F.; Sisi, M.; Zielli, T.; Tiseo, M.; Ardizzoni, A.. - In: IMMUNOTHERAPY. - ISSN 1750-743X. - 13:5(2021), pp. 363-369. [10.2217/imt-2020-0280]
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