Yet, just 2 years after the approval of pembrolizumab in patients with a PD-L1 tumor proportion score of 50% or greater, a phase 3 study of patients with untreated metastatic disease without EGFR mutations or ALK rearrangements/fusions reported that adding pembrolizumab to standard chemotherapy also improves overall survival compared with chemotherapy alone, regardless of PD-L1 status (19). Here, CD274 is linked to metastatic neoplasm.