CD274 and small cell lung carcinoma: The UK’s National Institute for Health and Care Excellence currently limits approval to new therapies based on a cost-benefit threshold of £20 000 to £30 000 (approximately $25 000-$39 000) per QALY.32 Atezolizumab, an immunotherapy similar to durvalumab that targets PD-L1, is accordingly approved in the metastatic NSCLC setting33 in both intravenous and subcutaneous formulations,34 although the agent does not retain such approval in small-cell lung cancer due to a higher estimated ICER.