Abstract
Pembro (programmed death protein 1 [PD-1] inhibitor) ± platinum (Pt)-based chemotherapy (CT), with pembro maintained until progression, is a standard 1L treatment for advanced/metastatic NSCLC. However, durable long-term benefit is limited to a small subset of patients. Nira, a poly(ADP-ribose) polymerase inhibitor (PARPi), promotes PARP trapping, activates the STING pathway, recruits T cells, and upregulates PD-L1, making it a promising partner for PD-1 inhibitors. Nira crosses the blood–brain barrier in animal models with 34-fold higher brain tissue exposure than other PARPi, suggesting it may reduce risk/progression of brain metastasis (BM).
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