Since pembrolizumab singe-agent is only indicated in NSCLC patients with ≥50% PD-L1 expression in the frontline setting (33, 34), this study established CIT as an alternative first-line therapeutic approach for nonsquamous NSCLC patients with <50% tumor PD-L1 expression, who do not harbor targetable mutations. This evidence concerns the gene CD274 and non-small cell lung carcinoma.