Figure 6.

Combined EML4-ALK inhibition with PD-1/PD-L1-directed immunotherapy. This schematic figure illustrates how PD-L1 upregulation is regulated by EML4-ALK through the MAPK and PI3K/AKT signalling pathways. PD-L1 molecules on the surface of ALK+ NSCLC tumour cells interact with PD-1 receptors on T cells to promote their inactivation and apoptosis. A combination of ALK TKIs and PD-1/PD-L1 axis inhibition, as well as targeting the signalling pathways activated by ALK, could be effective approaches to promote activation of the immune system and tumour eradication.