According to current approval in Italy, ICIs in combination with chemotherapy are used as first-line treatment for advanced NSCLC patients with PD-L1 expression lower than 50%, while monotherapy with pembrolizumab [a fully humanized immunoglobulin G4 (IgG4) monoclonal antibody against programmed cell death-1 (PD-1)] is indicated in the same setting when PD-L1 expression is ≥ 50% [9]. This evidence concerns the gene PDCD1 and non-small cell lung carcinoma.