Evaluation of rare but severe immune related adverse effects in PD-1 and PD-L1 inhibitors in non-small cell lung cancer: a meta- analysis

Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) inhibitors are thriving in anti-cancer treatment. PD-1 was expressed by activated T lymphocytes. It combines with its ligands PD-L1 to restrict the activation of T lymphocytes and prevent autoimmune disease. Monoclonal antibodies targeting PD-1 and PD-L1 can block the immune checkpoint and eliminate the inhibition of T lymphocytes activation. As a result, they largely enhance immune reactions to fight against malignant tumors (1,2). Several PD-1 inhibitors (nivolumab and pembrolizumab) and PD-L1 inhibitors (atezolizumab, avelumab and durvalumab) are showing distinct activities and efficacy in treatment of advanced melanoma, renal cell carcinoma and non-small cell lung cancer (NSCLC) or Hodgkin lymphoma