We observed that patients with good performance status who were prescribed first-line pembrolizumab monotherapy for metastatic NSCLC with PD-L1 expression ≥50% and no known EGFR, ALK, or ROS1 alterations experienced clinical outcomes similar to those in the KEYNOTE trials, including OS, real-world progression-free survival (rwPFS), and real-world tumor response rate (rwTRR) for the patient cohort with median follow-up of 15.5 months (12). This evidence concerns the gene ALK and non-small cell lung carcinoma.