For patients with advanced NSCLC and a PD-L1 tumor proportion score of 1% or higher and 50% or higher, 2 therapeutic regimens are approved for use: ICI alone or in combination with chemotherapy.1,2,4,27 Because there are no prospective data comparing ICI alone with ICI plus chemotherapy, our results suggest that for patients with PD-L1 tumor proportion score of 1% to 49% or 50% or higher, and very high TMB, ICI may be a reasonable treatment option as monotherapy, sparing the potential toxicities of adding chemotherapy. This evidence concerns the gene CD274 and neoplasm.