On safety, in combination with chemotherapy, sintilimab has minimal toxicity, followed by pembrolizumab+chemo.<h4>Conclusions</h4>In advanced NSCLC patients with negative PD-L1 expression, pembrolizumab+chemo ranks first in the efficacy of OS and does not apparently increase the incidence of any grade ≥ 3 AE as compared with chemo alone. Here, CD274 is linked to non-small cell lung carcinoma.