According to the published trial results in first line treatment, pembrolizumab monotherapy should be the first choice in patients with PD-L1 expression on at least 50% of tumor cells and no EGFR and ALK alterations, while for the remaining patients with lower PD-L1 expression pembrolizumab or atezolizumab combined with chemotherapy demonstrated better outcomes than chemotherapy alone. The gene discussed is ALK; the disease is neoplasm.