Immune checkpoint inhibitors (ICIs) are standard treatments for patients with lung cancer.
PD-1/PD-L1 or CTLA4 antibodies are chosen as the first-line therapy, contributing to the longterm
survival and tolerability. Unlike molecular targeting agents, such as gefitinib, lung cancer
patients with a poor performance status (PS) display unsatisfactory clinical improvements after ICI
treatment. Several previous reports also demonstrated that the PS is identified as one of the most
probable prognostic factors for predicting poor outcomes after ICI treatment. However, first-line
pembrolizumab seemed to be effective for lung cancer patients with a PS of 2 if PD-L1 expression
was greater than 50%. Currently, the induction of ICIs in patients with lung cancer with a poor PS is
controversial. These problems are discussed in this review.
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