Eficacia y seguridad de la inmunoterapia a base del pembrolizumab en cáncer de pulmón estadio IIIB: revisión sistemática

Abstract

Introduction: Worldwide, non-small cell lung cancer (NSCLC) represents a priority public health challenge due to its high mortality rate, particularly in advanced stages such as stage IIIB. Immunotherapy has emerged as an innovative alternative, with pembrolizumab, a PD-1 inhibitor, being one of the most relevant drugs, aimed at prolonging survival and optimizing quality of life. Objective: To evaluate the efficacy and safety of pembrolizumab as immunotherapy in patients with stage IIIB NSCLC. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines. Studies published between 2019 and 2025 in databases such as Scopus, PubMed, and ScienceDirect were included, using descriptors related to NSCLC, stage IIIB, immunotherapy, and pembrolizumab. Strict inclusion and exclusion criteria were applied, prioritizing clinical trials. Results: Ten clinical trials were selected, evaluating overall survival, progression-free survival, and objective tumor response. The most common adverse effects were fatigue, diarrhea, rash, and endocrine dysfunction. Serious events, such as pneumonitis or immune-mediated hepatitis, were uncommon and generally manageable. Conclusions: Pembrolizumab proves to be an effective and safe option for patients with stage IIIB NSCLC, consistently improving the most relevant clinical outcomes and maintaining a manageable toxicity profile. Its incorporation into multimodal regimens strengthens its role as a reference treatment in this context. Keywords: lung cancer, NSCLC, pembrolizumab, immunotherapy