In metastatic disease, NCCN-endorsed first-line options include single agent pembrolizumab (PD-L1 ≥ 50%, no targetable mutations), or combination therapy with pembrolizumab/platinum-pemetrexed (non-squamous histology, all PD-L1 expression) based on KEYNOTE-189 [46,50]. The gene discussed is CD274; the disease is metastatic neoplasm.