However, whether ICI plus chemotherapy is effective and safe for frail patients, such as older patients or those with poor ECOG PS, remains uncertain.7,8,10,11,12 In contrast, several previous studies51,52 have shown the efficacy and safety of pembrolizumab monotherapy in these frail populations; therefore, pembrolizumab monotherapy may be a more reasonable treatment option than ICI plus chemotherapy for frail patients with NSCLC with high PD-L1 TPS in a clinical setting. This evidence concerns the gene CD274 and non-small cell lung carcinoma.