Pembrolizumab in First Line Treatment of Advanced NSCLC Patients With PD-L1 Low Tumors.

Exclusion Criteria

• •The subject must be excluded from participating in the trial if the subject:
• •1. Has an EGFR sensitizing mutation and/or an ALK translocation.
• •2. Has a PD-L1 expression assessed as "high" by the central laboratory
• •3. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
• •4. Has a known history of active TB (Bacillus Tuberculosis).
• •5. Hypersensitivity to Pembrolizumab or any of its excipients.
• •6. Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
• •7. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent.
• •* Note: Subjects with ≤ Grade 2 neuropathy are an exception to this criterion and may qualify for the study.
• •* Note: If subjects received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
• •8. Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
• •9. Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
• •10. Has a history of non-infectious pneumonitis that required steroids or has current pneumonitis.
• •11. Has an active infection requiring systemic therapy.
• •12. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
• •13. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
• •14. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment.
• •15. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
• •16. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
• •17. Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA \[qualitative\] is detected).
• •18. Has received a live vaccine within 30 days of planned start of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines, and are not allowed.