Study of Aerosolized Antibiotics and Pembrolizumab in Advanced Non-small Cell Lung Cancer

Inclusion Criteria

• •1. Histologically or cytologically non-small cell lung cancer confirmed by outside pathology report or via the Laboratory of Pathology, NCI.
• •2. Have measurable disease, per RECIST 1.1, that is not amenable to surgery.
• •3. PD-L1 Tumor Proportion Score (TPS) \>=1% detected at any time since diagnosis, based on a pathology report from an outside hospital or Laboratory of Pathology, NCI. PD- L1 expression testing must be conducted using one of the FDA approved diagnostic devices listed here: https://www.fda.gov/medical-devices/in-vitro-diagnostics/list- cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools.
• •4. Patient s disease has progressed after FDA-approved frontline therapy for NSCLC.
• •5. Age \>=18 years.
• •6. ECOG performance status \<=2.
• •7. Must have adequate organ and marrow function as defined below:
• •* Leukocytes \>=3,000/mcL
• •* absolute neutrophil count \>=1,500/mcL
• •* platelets \>=100,000/mcL
• •* total bilirubin\<TAB\>within normal institutional limits
• •* AST/ALT \<=2.5 X institutional upper limit of normal
• •* creatinine clearance \>=60 mL/min/1.73 m\^2 (calculated based on CKD-EPI formula or directly measured) for participants with creatinine levels above institutional normal.
• •10. Human immunodeficiency virus (HIV)-infected participants on effective anti-retroviral therapy with undetectable viral load within the 6 months before study treatment initiation are eligible for this trial.
• •11. For participants with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
• •13. Individuals of child-bearing potential (IOCBP) must agree to use effective contraception (e.g., hormonal intrauterine device \[IUD\], tubal ligation, partner has had prior vasectomy) beginning at study entry until 4 months after the completion of therapy. Note: abstinence, defined as no heterosexual sexual intercourse when this is in line with the preferred and usual lifestyle of the participant, is also acceptable.
• •14. Breastfeeding participants must be willing to discontinue breastfeeding for the duration of study treatment.
• •15. Ability of participant to understand and the willingness to sign a written informed consent document.