OnCo
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PD-1 blockade + chemotherapy in PD-L1-low NSCLC

When the tumour shows little PD-L1, immunotherapy alone is weak, but adding chemotherapy makes it work for most patients.

KEYNOTE-189 (non-squamous) and KEYNOTE-407 (squamous) showed OS benefit across PD-L1 strata including <1%. POSEIDON adds tremelimumab for PD-L1-negative and STK11/KEAP1-mutant disease. The standard control arm for every new first-line lung regimen.

Rationale
Chemotherapy releases antigen and depletes suppressive cells, priming a response that PD-1 blockade sustains; benefit is independent of PD-L1 level.
Evidence
Multiple phase 3 with 5-year OS data.

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