For patients with metastatic NSCLC, tumor genomic typing of NSCLC is important before starting the ICI therapy, not only because ICIs have low or inferior effect in EGFR-mutant or ALK-rearranged NSCLC, but also they have been associated with increased incidence and severity of interstitial lung disease and immune-mediated adverse effects (including pneumonitis, colitis and hepatitis) when they are in sequential or concurrent use with EGFR TKIs in patients with metastatic NSCLC [13, 78]. This evidence concerns the gene EGFR and pneumonitis.