Immunotherapy in NSCLC: When and Why It Is Used

What immunotherapy does

Immune checkpoint inhibitors release the brakes on the patient's own immune system so it can attack tumor cells. In NSCLC they target pathways such as PD-1 and PD-L1 and are now standard across many stages.

Where it fits in the treatment sequence

• Metastatic disease: PD-L1-high tumors may receive immunotherapy alone; most others get immunotherapy combined with chemotherapy.
• Early-stage and resectable disease: neoadjuvant or adjuvant immunotherapy before or after surgery improves outcomes in selected patients.
• Unresectable stage III: consolidation immunotherapy after concurrent chemoradiation is a standard approach.

Why PD-L1 testing precedes it

PD-L1 expression helps estimate the chance of benefit and informs whether immunotherapy is used alone or with chemotherapy. It is one input alongside staging and performance status.