Immunotherapy supplanting chemotherapy for upfront treatment of advanced non-small cell lung cancer: what’s next?

Pembrolizumab (Keytruda, Merck & Co) is the first immunotherapy to be approved by FDA in the USA and by EMA in Europe for first-line treatment of patients with advanced non-small cell lung cancer (NSCLC) and high PD-L1 expression (tumor proportion score of 50% or above). Up to now, a chemotherapy doublet has been the standard of care for these patients, except in patients with advanced NSCLC harboring targetable genomic alterations such as EGFR mutations or ALK rearrangements.