Role of immunotherapy in the treatment of metastatic non-small cell lung cancer

Immunotherapy with checkpoint inhibitors (PD-1/PD-L1) has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC), significantly improving patient survival. This article reviews key drugs such as nivolumab, pembrolizumab, and atezolizumab, as well as the domestic drug prolgolimab, their mechanisms of action, and clinical efficacy. Special attention is given to the role of biomarkers, including PD-L1 expression and tumor mutational burden (TMB), in personalizing therapy. Treatment strategies such as monotherapy, combinations of immunotherapies, and their integration with chemotherapy are discussed, along with results from major clinical trials (KEYNOTE-024, CheckMate 227, IMpower110, etc.). The benefits of combined approaches, including long-term remissions, are highlighted, while challenges such as resistance, toxicity, and the need for further research into novel biomarkers are addressed.