Pembrolizumab 派姆单抗(Keytruda健痊得, 默沙东)
The NCCN Panel recommends pembrolizumab (category 1) as subsequent therapy for patients with metastatic non-squamous or squamous NSCLC and PD-L1 expression. NCCN小组推荐派姆单抗（1类）作为转移性非鳞或鳞型NSCLC并且表达PD-L1患者的后续治疗。
如果病人身体非常差常病不起情况的不建议用药PD1或者必须遵医嘱进行用药。
由于PD1抗体起效时间和观察和评估效果时间所以已经告知寿命短于3个月病人慎用
肝功能不健全或严重受损的病人要遵医嘱
本身有自身免疫疾病的人群慎用。比如：红斑狼疮。
之前接受过器官移植手术的病人一定要遵医嘱用药。
要严重肺炎病人也是不建议用药
瑞斯国际hpv2030希望对每个癌症病人及家属提供香港PD1抑制剂会诊订购便利，为晚期癌症病人延长寿命做出快而有效的服务。PD1抑制剂用药一般是2-3周用药一次每次用药建议60分钟以上一般是三个月为一个观察期。
For the 2016 update (Version 4), the NCCN Panel revised the recommendation for pembrolizumab to category 1 (from category 2A) as subsequent therapy based on the randomized phase 2/3 trial (KEYNOTE-010).
基于随机2/3期试验（KEYNOTE-010），2016第4版更新，NCCN小组将派姆单抗作为后续治疗推荐从2A类修改为1类。
Previously (Version 1), the NCCN Panel had a category 2A recommendation for pembrolizumab based on the phase 1 KEYNOTE-001 trial and FDA approval.
基于1期KEYNOTE-001试验和FDA的批准，之前的第1版，NCCN小组将派姆单抗列为2A类推荐。
In addition, the NCCN Panel recommends immune checkpoint inhibitors, such as pembrolizumab and nivolumab, as preferred agents for subsequent therapy.
此外，NCCN专家组推荐免疫检查点抑制剂，如派姆单抗和尼鲁单抗作为后续治疗的首选药物。
As previously mentioned, human immune-checkpoint--inhibitor antibodies inhibit the programmed death (PD-1) receptor, which improves antitumor immunity; PD-1 receptors are expressed on activated cytotoxic T-cells.
如前所述，人类免疫检查点抑制剂抗体抑制程序性死亡（PD-1）受体，从而改善抗肿瘤免疫；在活化的细胞毒性T细胞上表达PD-1受体。
A recent randomized phase 2/3 trial (KEYNOTE-010) assessed pembrolizumab in patients with previously treated advanced non-squamous and squamous NSCLC who were PD-L1 positive (≥ 1%); most were current or former smokers.
最近一项随机2/3试验（KEYNOTE-010）评估了派姆单抗治疗既往治疗过的、PD-L1阳性的晚期非鳞和鳞型NSCLC患者（≥1%）；大部分都是当前或既往吸烟者。
There were 3 arms in this trial: pembrolizumab at 2 mg/kg, pembrolizumab at 10 mg/kg, and docetaxel at 75 mg/m2 every 3 weeks.
在这项试验中有3组：派姆单抗2mg/kg、派姆单抗10mg/kg、多西他赛75mg/㎡每3周1次。
The median overall survival was 10.4 months for the lower dose of pembrolizumab, 12.7 months for the higher dose, and 8.5 months for docetaxel.
中位总生存期：派姆单抗较低剂量组为10.4个月、高剂量组为12.7 个月，而多西他赛组为8.5个月。
Overall survival was significantly longer for both doses of pembrolizumab when compared with docetaxel (pembrolizumab 2 mg/kg: HR 0.71; 95% CI, 0.58–0.88; P=.0008) (pembrolizumab 10 mg/kg: (HR 0.61; CI, 0.49–0.75; P<.0001).
与多西他赛相比，两个剂量的派姆单抗组总生存期显著更长（派姆单抗2mg/kg：HR 0.71；95% CI，0.58–0.88；P = 0.0008）（派姆单抗10mg/kg：HR 0.61；CI，0.49–0.75；P<0.0001) 。
For those patients with at least 50% PD-L1 expression in tumor cells, overall survival was also significantly longer at either dose of pembrolizumab when compared with docetaxel (pembrolizumab 2 mg/kg: 14.9 vs. 8.2 months; HR 0.54; 95% CI, 0.38–0.77; P=.0002) (pembrolizumab 10 mg/kg: 17.3 vs. 8.2 months; HR 0.50; CI, 0.36–0.70; P<.0001).
对于那些至少50%的肿瘤细胞表达PD-L1的患者，与多西他赛相比，派姆单抗两个剂量中的任一剂量总生存期也显著更长（派姆单抗2mg/kg：14.9对8.2个月；HR 0.54；95 %CI，0.38-0.77；P =0.0002) (派姆单抗10mg/kg：17.3对8.2个月；HR 0.50；CI，0.36-0.70；P<0.0001)。< span="">
When compared with docetaxel, there were fewer grade 3 to 5 treatment-related adverse events at either dose of pembrolizumab (pembrolizumab 2 mg/kg: 13% [43/339] of patients, pembrolizumab 10 mg/kg: 16% [55/343], and docetaxel: 35% [109/309]).
与多西他赛相比，任一剂量的派姆单抗3-5度治疗相关不良事件较少（派姆单抗2mg/kg：13% [43/339]、派姆单抗10mg/kg：16% [55/343]，而多西他赛：35% [109/309]）。
