In this evolving scenario, in Italy, platinum-based chemotherapy plus ICI is the standard first-line in metastatic NSCLC and programmed-death ligand 1 (PD-L1) expression < 50%, while in the presence of PD-L1 ≥50%, the indication is usually to immunotherapy with pembrolizumab, an IgG4 antibody that targets the programmed cell death protein-1 (PD-1) [5]. The gene discussed is CD274; the disease is non-small cell lung carcinoma.