Several factors such as lower PD-L1 expression and tumor mutational burden, increased risk of pulmonary toxicity in patients on prior or concurrent osimertinib therapy, limited efficacy with ICIs monotherapy and risk of developing hyper-progressive disease (HPD), warrant caution for their use in EGFR mutant lung cancer patients [246, 247]. The gene discussed is EGFR; the disease is lung carcinoma.