The use of immune-checkpoint inhibitors targeting the CTLA-4, PD-1, or PD-L1 signalling axis in the modulation of anti-tumour T-cell activity has revolutionised the treatment of lung cancer in different settings.1 In patients with PD-L1 expression of at least 50%, pembrolizumab (anti PD-1) and atezolizumab (anti PD-L1) have been approved by the US Food and Drug Administration as first-line single-agent treatments because they significantly prolong overall survival compared with platinum-based chemotherapy, in patients with both squamous and non-squamous tumours without sensitising EGFR mutations or ALK rearrangements.
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