This study was aimed at evaluating the real-world clinical outcomes of chemo-immunotherapy (CT-IT) with cis/carboplatin, pemetrexed and pembrolizumab for the first-line (1L) treatment of advanced lung adenocarcinoma (LUAC) patients in Italy….ORR was 38.8% (95% CI, 34.2-43.6) in PD-L1 < 1%, 47.0% (95% CI, 42.7-51.3) in PD-L1 1-49% and 42.1% (95% CI, 26.3-59.2) in PD-L1 ≥ 50%, respectively....After a median follow-up for surviving patients of 17.0 months (95% CI, 16.1-17.9), median real-world progression-free survival (rwPFS) was 9.9 months (95% CI, 8.8-11.2): 9.6 months (95% CI, 8.3-11.3) in PD-L1 < 1%, 10.2 months (95% CI, 8.9-11.9) in PD-L1 1-49% and 8.7 months (95% CI, 5.3-29.3) in PD-L1 ≥ 50%. Median overall survival (OS) was 16.1 months (95% CI, 14.4-18.8): 15.5 months (95% CI, 13.7-19.0) in PD-L1 < 1%, 16.6 months (95% CI, 14.0-20.4) in PD-L1 1-49% and 12.2 months (95% CI, 7.2-NE) in PD-L1 ≥ 50%.

In pembrolizumab-treated patients, OS differences between the PD-L1 high-expressing (>50%) and low-expressing (1-49%) groups were not statistically significant (p=0.13), but these differences were significant between the high-expressing and non-expressing groups (p = 0.03)...Patients whose tumors displayed high levels of PD-L1 expression benefitted more from pembrolizumab than those whose tumors were negative.

60-year-old man, stage IVB lung adenocarcinoma, high expression of PD-L1. After brain metastasectomy, drug therapy with carboplatin, pemetrexed, and pembrolizumab was started. Currently, 41 months have passed since the start of drug therapy, and the disease is under control, and maintenance therapy with pemetrexed and pembrolizumab is being continued.

...we report a case of an 80-year-old male affected by a stage IIIB lung adenocarcinoma with overexpression of PD-L1 (TPS 90%) treated with pembrolizumab, an immune checkpoint inhibitor targeting PD-1/PD-L1 pathways, which shows a complete resolution of lung lesion after four cycles of treatment.