Advances in PD-1 and PD-L1 inhibitors targeted therapies for NSCLC: Mechanisms, Biomarkers, Combination Therapies

NSCLC is the broadest malignant disease and a significant instigator of cancer-related mortality worldwide. Fortunately, recent advances in precision immunotherapy, particularly those aiming at the PD-1 and PD-L1 pathways, have introduced an encouraging new avenue for the treatment of NSCLC. Nevertheless, there is a paucity of research examining biomarkers that are pivotal for forecasting PD-1 and PD-L1 inhibitor therapy. Those biomarkers are crucial for evaluating the development of resistance to such treatments and for assessing the efficacy of therapeutic interventions. The review begins by outlining the mechanisms through which PD-1 and PD-L1 inhibitors act in the therapy of NSCLC and then proceeds to elucidate the cellular immune escape pathways that are relevant in this context. Subsequently, the article explores the potential of biomarkers as predictors and prognosticators of efficacy in PD-1 and PD-L1 inhibitor therapy for NSCLC. Moreover, the review examines the potential of integrating PD-1 and PD-L1 inhibitors with other treatment approaches, emphasizing the synergistic effects and augmented efficacy of such combinations. The review concludes with a discussion of future directions, which will assist clinicians and researchers in optimizing the utilization of immunotherapy for the treatment of NSCLC.