晚期非小細胞肺癌是高度致命的癌症，過去治療的選擇只有化學治療或標靶治療。免 疫檢查點抑制劑是目前唯一證實有效的免疫治療，它藉由PD-1、PD-L1 或CTLA-4 負向調 控T 細胞功能，增強其對腫瘤細胞的攻擊達到治療的效果。Nivolumab 和Pembrolizumab 是 PD-1 單株抗體，Nivolumab 適用於晚期非小細胞肺癌病人的第二線治療，不須檢測癌細胞 PD-L1；Pembrolizumab 適用在癌細胞PD-L1 陽性的晚期非小細胞肺癌病人的第一線或第二線 治療。Atezolizumab 是PD-L1 的單株抗體，適用於晚期非小細胞肺癌病人的第二線治療，不 須檢測癌細胞PD-L1。免疫治療後腫瘤的變化和傳統治療不同，治療的效果要用免疫相關反 應評估標準追蹤。免疫檢查點抑制劑治療後產生的副作用比化療低，但少數病人會有免疫相 關副作用，需要及早發現並加以處理。

Advanced or end stage non-small cell lung cancer(NSCLC) is a highly lethal disease. Current treatment is limited to chemotherapy or targeted therapy. Immune check point blockade is the only proven effective immunotherapy in NSCLC. Antibodies that target cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathway (PD-1/PD-L1) have demonstrated promise results against cancer cells. However, immunotherapy presents unusual kinetics of tumor response, immune-related response criteria (irRC) was developed to evaluate therapeutic benefit. Although immunotherapy has a more favorable adverse event profile compared with chemotherapy, it generates dysimmune toxicities called immune-related adverse events (irAEs). Early identification and management of irAEs can optimize outcomes.