EGFR and non-small cell lung carcinoma: Fourth, EGFR-TKIs may not be optimal for EGFR-TKI-naïve, high PD-L1 expressing, EGFR-mutated NSCLC as the first-line treatment due to a possible association between high PD-L1 expression and primary resistance to EGFR-TKIs [177, 178].