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Cisplatin + pembrolizumab + pemetrexed is a combination regimen used primarily as first-line treatment for metastatic non-squamous non-small cell lung cancer (NSCLC) in adults whose tumors lack EGFR or ALK mutations. Cisplatin is a platinum-based chemotherapy agent that causes DNA crosslinking and apoptosis in rapidly dividing cells. Pemetrexed is an antifolate antineoplastic agent that inhibits multiple folate-dependent enzymes involved in nucleotide synthesis, thereby blocking DNA and RNA synthesis. Pembrolizumab is a humanized monoclonal antibody targeting the programmed cell death protein 1 (PD-1) receptor on T-cells, acting as an immune checkpoint inhibitor to enhance anti-tumor immune responses by preventing tumor-mediated T-cell deactivation[6][7][1]. This combination has demonstrated improved overall survival and progression-free survival compared to chemotherapy alone, with manageable toxicity profiles[1][3][4].
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