More recently, the role of chemotherapy as first line treatment in mutation-negative advanced NSCLC was challenged by dual blockade of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death 1 (PD1) (median OS: 14.9 vs. 17.1 months) [134]. This evidence concerns the gene CTLA4 and non-small cell lung carcinoma.